title: Declining mortality rates for nonmelanoma skin cancers in West Germany, 1968-99.
abstract: BACKGROUND
  Mortality analyses based on routine death certification provide a rough guide to the magnitude of nonmelanoma skin cancer (NMSC) mortality.
  
  
  OBJECTIVE
  To examine time trends in NMSC mortality over a 32-year period for the territory of West Germany which included a population of about 66 million people.
  
  
  METHODS
  We analysed the NMSC skin cancer mortality data (1968-99) from the former West Germany including West Berlin. We calculated the age-specific and age-standardized mortality rates (World Standard Population) and used a Poisson regression to estimate the underlying age, cohort and period effects.
  
  
  RESULTS
  The age-standardized mortality rate decreased from 0.56 per 100,000 in 1968 to 0.24 per 100,000 in 1999 among men and from 0.42 per 100,000 in 1968 to 0.11 per 100,000 in 1999 among women. The estimated annual percentage decrease of the age-standardized NMSC skin cancer mortality rate was -2.3%[95% confidence interval (CI) -2.6 to -1.9] among men and -3.5% (95% CI -4.0 to -3.1) among women during the period 1968-99. This decline is mainly due to a rate decrease in people aged 80 years or more. The change in NMSC skin cancer mortality rates was best explained by age, cohort and period effects.
  
  
  CONCLUSIONS
  The NMSC mortality in West Germany showed a continuous decrease from 1968 to 1999. The favourable mortality decline by birth cohort in the most recent birth cohort is an indicator of a likely decline in mortality in the future.
authors.affiliation: Epidemiology Unit. Institute for Medical Informatics, Biometry and Epidemiology, University Hospital of Essen, Hufelandstr. 55, 45122 Essen, Germany. andreas.stang@uni-essen.de
authors.forename: A
authors.initials: A
authors.lastname: Stang
authors.forename: K-H
authors.initials: KH
authors.lastname: Jöckel
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D005860:Germany, West / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000401:mortality*