A reversal in the long‐term increase in deaths attributable to malignant melanoma

Abstract

For a few years in the 1980s, United States mortality rates suggested a plateau in the long‐term increase for malignant melanoma. However, temporary plateaus in the increase of the age‐adjusted rate by year of death have occurred in previous decades, only to be followed by a continued upward increase, with a long‐term rise of about 2% per year. To determine whether a cessation in the long‐term increase might be in progress, death rates were analyzed by year of birth, age at death, and year of death: (1) the long‐term patterns of change are best described by birth cohort rather than by time period of death, indicating that analyses by a year of birth are key to a better understanding of the long‐term trends; (2) in both men and women, evidence for a change in slope begins among those born in the early 1930s; (3) the decline in the rates begins among women born since the early 1930s and among men born since the early 1950s: the slope for men is ‐0.2661 (95% confidence limits [CL] = −0.380 to −0.152), and, for women, the slope is ‐0.02354 (95% CL = ‐0.041 to ‐0.005); (4) long‐term Connecticut and US mortality trends were similar in pattern and direction, and long‐term Connecticut incidence rates showed a persistent increase through the 1955 to 1965 birth cohorts. These analyses suggest a persistent cessation in the long‐term increase and a downward trend in death rates from this cancer. Copyright © 1992 American Cancer Society