Has mortality from malignant melanoma stopped rising in Spain? Analysis of trends between 1975 and 2001

BACKGROUND: There have been suggestions that mortality from cutaneous malignant melanoma (CMM) is starting to level off in the European Union. OBJECTIVES: To analyse changes in CMM mortality trends in Spain during 1975-2001 using joinpoint regression models. METHODS: Mortality data were obtained from the National Statistics Institute. For each gender, age group-specific and standardized (overall and truncated) rates were calculated by the direct method (using the world standard population). The joinpoint analysis was used to identify the best-fitting points where a statistically significant change in the trend occurred. RESULTS: In women, there was a marked increase from 1975 to 1994 in age-adjusted (overall and truncated) CMM mortality rates [estimated annual percentage change (EAPC) 6.6% and 7.0%, respectively; P < 0.05], followed by a levelling off (EAPC - 0.3% and - 1.3%, respectively; not significant). In men, age-adjusted (35-64 years) mortality rates increased steadily from 1975 to 1991 (EAPC 9.1%, P < 0.05) and then levelled off. CONCLUSIONS: We confirmed that CMM mortality rates in Spain rose dramatically from the mid-1970s to the beginning of the 1990s, but we also found that mortality rates are now levelling off in middle-aged adults (35-64 years), following a similar tendency to that observed in other countries.