title: Has mortality from malignant melanoma stopped rising in Spain? Analysis of trends between 1975 and 2001.
abstract: BACKGROUND
  There have been suggestions that mortality from cutaneous malignant melanoma (CMM) is starting to level off in the European Union.
  
  
  OBJECTIVE
  To analyse changes in CMM mortality trends in Spain during 1975-2001 using joinpoint regression models.
  
  
  METHODS
  Mortality data were obtained from the National Statistics Institute. For each gender, age group-specific and standardized (overall and truncated) rates were calculated by the direct method (using the world standard population). The joinpoint analysis was used to identify the best-fitting points where a statistically significant change in the trend occurred.
  
  
  RESULTS
  In women, there was a marked increase from 1975 to 1994 in age-adjusted (overall and truncated) CMM mortality rates [estimated annual percentage change (EAPC) 6.6% and 7.0%, respectively; P < 0.05], followed by a levelling off (EAPC - 0.3% and - 1.3%, respectively; not significant). In men, age-adjusted (35-64 years) mortality rates increased steadily from 1975 to 1991 (EAPC 9.1%, P < 0.05) and then levelled off.
  
  
  CONCLUSIONS
  We confirmed that CMM mortality rates in Spain rose dramatically from the mid-1970s to the beginning of the 1990s, but we also found that mortality rates are now levelling off in middle-aged adults (35-64 years), following a similar tendency to that observed in other countries.
authors.affiliation: Dermatology Department, Virgen del Rocío University Hospitals, Avenida de Manuel Siurot s/n, 41013 Seville, Spain. aurelio.cayuela.sspa@juntadeandalucia.es
authors.forename: A
authors.initials: A
authors.lastname: Cayuela
authors.forename: S
authors.initials: S
authors.lastname: Rodríguez-Domínguez
authors.forename: J
authors.initials: J
authors.lastname: Lapetra-Peralta
authors.forename: J S
authors.initials: JS
authors.lastname: Conejo-Mir
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008545:Melanoma / Q000401:mortality*; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000401:mortality*; D013030:Spain / Q000453:epidemiology