OBJECTIVES: Malignant melanoma is the fifth most common cancer in the UK and a leading cancer in average years of life lost. The aim of this research was to describe the patient journey using digital real-world data and investigate melanoma care disparities based on deprivation index data.

METHODS: The Melanoma UK study is an observational, non-interventional digital registry of real-world data from people living with melanoma and its treatment in the UK. It ran from 2016 to 2021 and has 1,072 consenting participants with 2.6 years’ average follow-up. Components of the disease pathway were mapped: diagnosis and staging; interventions received; and monitoring/management of disease and treatment-related adverse events. Deprivation index scores were assigned based on official English indices for residential postcodes.

RESULTS: There were 892 participants with postcode information and linked deprivation data. Participants resided in areas less deprived on average than the general population (11% and 28% of the study in the bottom and top quintile, respectively). There was no clear social gradient to disease stage across deprivation categories, but ECOG status had a gradient, with people better off in the least deprived areas. Rates of use of immunotherapy increased in lower-deprivation areas across all products. No statistically significant difference was seen in regimen (chi-squared p-values 0.45 monotherapy, 0.08 combination therapy), but ~60% of drug therapy utilization was in the two least deprived areas. Surgeries were nearly uniform (chi-squared p-value 0.99), however.

CONCLUSIONS: Multiple challenges exist in using digital real-world data to map the patient journey e.g., low completion rates and population representativeness. However, despite the limitations, these data show demonstrable social gradients in access to key pieces of treatment such as drug therapies. Reducing health disparities in the UK will require firmer understanding of data at an individual level.