Trends in mortality from malignant melanoma in Sweden, 1970-1996

BACKGROUND. The rise in melanoma-related mortality in Sweden has been less pronounced than the increase in incidence. Interventional activities aimed at early detection may have contributed to this discrepancy. METHODS, Individuals with malignant melanoma as the underlying cause of dea th between 1970 and 1996 (n = 7177) formed the basis of tills study. Annual age standardized mortality rates were calculated using the direct method o f standardization with the Swedish population of 1970 as reference. Tempora l trends in the standardized rates were evaluated using a log-linear model. The effects of age, period, and cohort on the mortality trends were estima ted using a Poisson regression model. RESULTS. Since the mid-1980s, melanoma-related mortality in Sweden has leve led off, with no further increase during the last 10-15 years. The contribu tion to the mortality from noncutaneous melanoma was proportionally stable (20-25%) during the studied period. In females, a significant decrease in m ortality from cutaneous melanoma was shown for the period of 1987-1996 with an Estimated annual decrease of similar to 2.3% (95% confidence interval: -4.3 to -0.3). This trend appeared to be more pronounced in the Stockholm-G otland region. The observed trends were best explained with the age-period model ill both genders. CONCLUSIONS, Melanoma-related mortality in Sweden has leveled off since the mid-1980s. During the period 1987-1996, a statistically significant downwa rd trend was observed for females. This trend coincides with increased prev entional activities. (C) 2000 American Cancer Society.