Changing patterns of skin melanoma mortality in West Germany from 1968 through 1999

PURPOSE: Skin cancer incidence data from West Germany are available only for the territory of the Federal State of Saarland. We examined time trends in melanocytic and non-melanocytic skin cancer mortality for the territory of West Germany including a population of about 66 million people. METHODS: We analyzed the melanocytic and non-melanocytic skin cancer mortality data (1968-99) from West Germany including West Berlin. We calculated age-specific and age-standardized mortality rates and used Poisson regression to estimate underlying age, cohort, and period effect. RESULTS: The estimated percent annual increase of the skin melanoma mortality rate was 1.0% (95% CI, 0.7-1.3) among men and 0.5% (95% CI, 0.2-0.7) among women. This increase is mainly due to a rate increase in people aged 60 years or more. The skin melanoma mortality trend was best explained by age-, cohort-, and period effects. The risks increased in each successive birth cohort born between 1890 and roughly 1935. Thereafter, the risks declined through the most recent birth cohort born in 1975. CONCLUSIONS: Skin melanoma mortality in West Germany showed an increase from 1968 through 1999 in people aged 60 years or more. The favorable mortality decline by birth cohort in the most recent birth cohort is an important indicator of a likely decline in mortality over the coming years. Ann Epidemiol 2003; 13:436-442. (C) 2003 Elsevier Inc. All rights reserved.