Trends in melanoma mortality in Australia: 1950-2002 and their implications for melanoma control

To assess whether the stabilisation in melanoma mortality rates observed from 1985 to 1994 has progressed to a statistically significant decrease.

Joinpoint trends analyses of Australian melanoma mortality data between 1950 and 2002, stratified by age.

The latest data showed statistically significant decreases in mortality rates for both men and women younger than 55 years (percentage change per year, men 35-55 years: -2.4%; 95% CI -3.5% -- -1.3%; women: -2.9%; 95% CI -4.7%-- -1.1%). For ages 55-79 years, rates are now stable for both men (+0.3%; 95% CI -0.6%-- +1.1%) and women (-0.5%; 95% CI -1.4%-- +0.4%), whereas previously the rates were increasing. For both men and women 80 years or older, rates have continued their statistically significant increase of 3-4% per year.

Since no similar reductions in incidence have been reported, the most likely cause of the recent statistically significant decreases in mortality is early detection. Although it may be too early to be seeing the full benefits of primary prevention programs that started in the 1980s, they have the potential to lead to large reductions in mortality in the future.