title: 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.
authors.affiliation: Institute of Environmental Medicine, New York University Medical Center, NY.
authors.forename: G C
authors.initials: GC
authors.lastname: Roush
authors.forename: L
authors.initials: L
authors.lastname: McKay
authors.forename: T R
authors.initials: TR
authors.lastname: Holford
mesh_terms: D000293:Adolescent; D000328:Adult; D000375:Aging / Q000502:physiology; D015331:Cohort Studies; D003237:Connecticut / Q000453:epidemiology; D003643:Death; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008545:Melanoma / Q000453:epidemiology / Q000401:mortality*; D008875:Middle Aged; D012737:Sex Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology