Skin melanoma in Saarland: incidence, survival and mortality 1970-1996

Over the past few decades, the incidence of cutaneous malignant melanoma ha s been rising in both sexes in almost all developed countries, notably thos e with fair-skinned populations. Detailed population-based time trend analy ses of skin melanoma incidence and survival in Germany accounting for stage have not been published until now. We analysed skin melanoma data from the population-based Saarland Cancer Registry in Germany from 1970 to 1996. In cidence rates were age-standardized. We estimated 5-year disease-specific s urvival rates and evaluated the effects of sex, age, calendar period and st aging on the prognosis in Cox's proportional hazards models. From 1970-1972 to 1994-1996, melanoma incidence increased 170% from 2.4 to 6.5 per 100 00 0 person-years among men and 150% from 2.4 to 6.0 per 100 000 person-years among women. Mortality rates peaked in 1988-1990. After 1988-1990, mortalit y rates declined among women and remained roughly constant among men. The i ncrease in the incidence of localized melanoma and T1-T2 melanoma respectiv ely is driving the overall incidence trend. The improvement of survival ove r time is most likely due to earlier detection of skin melanoma. In the 199 0s, about 30% of all newly diagnosed skin melanoma had stage T3 or T4, impl ying that further improvement in survival by earlier detection is feasible. (C) 2001 Lippincott Williams & Wilkins.