Trends in mortality from malignant melanoma: an observational study of the World Health Organisation mortality database from 1985 to 2015


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Dorothy Yang1,Justin Salciccioli2,Dominic Marshall3,Joseph Shalhoub4

1Royal Free London NHS Foundation Trust,2Department of Medicine, Mount Auburn Hospital,3Oxford University Clinical Academic Graduate School, John Radcliffe Hospital,4Academic Section of Vascular Surgery, Department of Surgery and Cancer, Imperial College London

Abstract

Background

Malignant melanoma (MM) has the highest mortality among skin cancers. MM incidence is reported to have increased over the past decades, particularly in regions with predominantly fair-skinned populations. We report 30-year global MM mortality trends using the World Health Organisation (WHO) mortality database.

Method

An observational analysis of the WHO mortality database between 1985 and 2015 was performed. ICD-9 and 10 codes for MM were used to extract age-standardised death rates (ASDRs) for all countries classified as having high usability death registration data by the WHO. Trends were described using Joinpoint regression.

Results

33 countries were included in this analysis. For both sexes, 3-year average ASDRs for 2013-2015 were highest in Australia and Slovenia and lowest in Japan: rates of death were 5.72/100 000, 3.86/100 000, and 0.24/100 000 respectively in males, and 2.53/100 000, 2.58/100 000, and 0.18/100 000 respectively in females. In all countries, MM mortality remained greater in males than females across the observation period. All countries demonstrated increased mortality rates in males over the observation period except Czech Republic, which demonstrated a single decreasing trend in mortality on Joinpoint analysis (estimated annual percentage change -0.7%). More countries exhibited decreasing or stable MM mortality in females, with Israel and Czech Republic demonstrating the greatest percentage decreases in mortality rates over the observation period (-23.4% and -15.5% respectively).

Conclusion

There is a persisting global sex disparity in MM mortality over the past 30 years. In some regions, this is due either to greater increases in mortality rates in males compared to females, or to decreasing or stabilising mortality trends in females not paralleled in males. Future work will explore potential explanatory factors for the observed trends and sex disparity in MM mortality.