title: Skin cancer mortality in Germany before and after the post-communist transition.
abstract: OBJECTIVE
  Until now mortality trends of melanoma and nonmelanoma skin cancer (NMSC) in Germany have been studied only in West Germany. We were interested in comparing mortality trends of melanoma and NMSC in West and East Germany before and after the post-communist transition. By analyses of health care utilization data in West and East Germany, we explored potential reasons for mortality differences between these regions.
  
  
  METHODS
  We analyzed mortality data of skin melanoma and NMSC of West and East Germany (1980-2005). We calculated sex-specific age-standardized mortality rates using the World Standard Population. We calculated age-specific mortality rates (20-39, 40-59, 60-79, 80+ years).
  
  
  RESULTS
  Age-standardized skin melanoma mortality rates tended to be lower in East Germany than West Germany before reunification. After reunification rates became very similar. Age-standardized mortality rates of NMSC were continuously higher in East than West Germany. The mortality rate differences among East and West Germans in 1996-2005 are mainly due to 2.34- and 2.24-fold higher mortality rates among men and women aged 80 years, respectively, who live in East Germany.
  
  
  CONCLUSIONS
  Even 15 years after reunification, mortality of NMSC is still higher in East than West Germany, although incidence rates of squamous cell cancers of the skin are not higher in East Germany. Differences in the participation in early cancer detection and health care utilization in West and East Germany do not sufficiently explain our findings.
authors.affiliation: Clinical Epidemiology Unit, Institute of Medical Epidemiology, Biometry and Informatics, Medical Faculty, Martin-Luther-University of Halle-Wittenberg, Magdeburger Str. 8, 06097 Halle, Germany. andreas.stang@medizin.uni-halle.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Stang
authors.forename: Thomas
authors.initials: T
authors.lastname: Lampert
authors.forename: Thomas
authors.initials: T
authors.lastname: Uhlemann
authors.forename: Pietro
authors.initials: P
authors.lastname: Trocchi