先前的工作研究了社会决定因素对各种癌症的影响，但对眼眶癌症的分析有限。当前的文献往往关注社会经济地位和种族，对跨学科贡献的分析很少。我们检查了疾病控制和预防中心 (CDC) 社会脆弱性指数 (SVI) 衡量的社会决定因素，量化了美国各地眼部和眼眶黑色素瘤的差异。对监测中诊断为眼眶癌的 15,157 名患者进行了回顾性审查对 1975 年至 2017 年的流行病学和最终结果 (SEER) 数据库进行了分析，提取了 6139 例眼部黑色素瘤。 SVI 分数被提取并与 SEER 患者数据相匹配，分数由县人口普查区每个人口密度的加权平均值生成。主要结局是存活数月，而次要结局是高级分期、高分级和初次手术接受。随着 SVI 总分的增加，表明脆弱性增加，我们观察到黑色素瘤组织学的生存月数显着下降 23.1%（p < 0.001）和按主要站点划分为 19.6-39.7%。总 SVI 的增加表明较高分级的几率增加（比值比 [OR] 1.20，95% 置信区间 [CI] 1.02-1.43），并且手术干预的几率降低（OR 0.94，95% CI 0.92-0.96）。在四个主题中，社会经济地位（26.0%）和住房交通（14.4%）的贡献较大，而少数民族语言地位（13.5%）和家庭构成（9.0%）的贡献较小。 社会脆弱性增加根据 CDC SVI 及其子评分测量，成人眼眶黑色素瘤的预后和治疗因素显示出显着的不利趋势。分项分数量化了哪些社会决定因素对差异影响最大。这为提供者在患者护理中针对非临床因素影响最大的社会决定因素奠定了基础。© 2024。外科肿瘤学会。

Prior works have studied the impact of social determinants on various cancers but there is limited analysis on eye-orbit cancers. Current literature tends to focus on socioeconomic status and race, with sparse analysis of interdisciplinary contributions. We examined social determinants as measured by the Centers for Disease Control and Prevention (CDC) Social Vulnerability Index (SVI), quantifying eye and orbit melanoma disparities across the United States.A retrospective review of 15,157 patients diagnosed with eye-orbit cancers in the Surveillance, Epidemiology, and End Results (SEER) database from 1975 to 2017 was performed, extracting 6139 ocular melanomas. SVI scores were abstracted and matched to SEER patient data, with scores generated by weighted averages per population density of county's census tracts. Primary outcome was months survived, while secondary outcomes were advanced staging, high grading, and primary surgery receipt.With increased total SVI score, indicating more vulnerability, we observed significant decreases of 23.1% in months survival for melanoma histology (p < 0.001) and 19.6-39.7% by primary site. Increasing total SVI showed increased odds of higher grading (odds ratio [OR] 1.20, 95% confidence interval [CI] 1.02-1.43) and decreased odds of surgical intervention (OR 0.94, 95% CI 0.92-0.96). Of the four themes, higher magnitude contributions were observed with socioeconomic status (26.0%) and housing transportation (14.4%), while lesser magnitude contributions were observed with minority language status (13.5%) and household composition (9.0%).Increasing social vulnerability, as measured by the CDC SVI and its subscores, displayed significant detrimental trends in prognostic and treatment factors for adult eye-orbit melanoma. Subscores quantified which social determinants contributed most to disparities. This lays groundwork for providers to target the highest-impact social determinant for non-clinical factors in patient care.© 2024. Society of Surgical Oncology.