Trends of keratinocyte carcinoma mortality rates in the United States as reported on death certificates, 1999 through 2010.
BACKGROUND
From 1969 to 1998, keratinocyte carcinoma (KC) mortality rates declined as reported on death certificates, despite increasing incidence of KC.


OBJECTIVE
To estimate KC mortality trends from 1999 to 2010 in the United States.


METHODS
Descriptive and linear regression analysis using population-based death certificate data from the US National Center for Health Statistics.


RESULTS
On average, 1,491 deaths from nongenital KC and 1,058 deaths from genital KC were reported annually. Keratinocyte carcinoma mortality rates were stable or increasing over the study period. Highest nongenital mortality rates were seen in those older than 85 years (p < .001), men (p < .001), whites (p < .001), the South for white males (p = .001) and white females (p = .018), and nonmetropolitan areas for white males (p <.001), white females (p < .001), and black females (p = .005). Correlation between state UV Index and KC mortality existed for men (p = .004) but not for women (p = .379). Genital KC deaths increased with age (p < .001), in women (p < .001), and in less urbanized areas for white males (p < .001).


CONCLUSIONS
Keratinocyte carcinoma poses a serious health burden, which may be underestimated by death certificate reporting. Mortality rates are no longer declining. Increasing awareness of genital and nongenital KC, especially the elderly, and population-based studies with controlled reporting of KC mortality are needed.
*Department of Dermatology, Baylor College of Medicine, Houston, Texas; †Dermatoepidemiology Unit, VA Medical Center Providence, Providence, Rhode Island; ‡Department of Dermatology, Rhode Island Hospital, Providence, Rhode Island; Departments of §Dermatology and ‖Epidemiology, Brown University, Providence, Rhode Island.
Wesley
W
Wu
Martin A
MA
Weinstock
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000401:mortality*; D003644:Death Certificates; D005260:Female; D006801:Humans; D015603:Keratinocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D012878:Skin Neoplasms / Q000401:mortality*; D014481:United States / Q000453:epidemiology