Mortality and fatality of cutaneous malignant melanoma in Sweden, 1982-1986

Among almost all cases of death from cutaneous malignant melanoma in Sweden during the 5-year observation period of 1982-86 (n = 1406), 58.5% were male. For both sexes, considered together, 80.5% were aged greater than 49 yr at the time of death; 62.9% aged greater than 59 yr, and 36.7% aged greater than 69 yr. Disease fatality, assessed as the sex and age-specific mortality between 1982 and 1986 in proportion to the age and sex-specific incidence in 1977 and 1982, increased significantly (P less than 0.001) with age in both sexes, in terms of distributional heterogeneity. Likewise, in both sexes, disease fatality was higher (P less than 0.025) in the area of Sweden north of the N 60 degrees latitude line rather than south of it. As it is a crucial measure of treatment efficacy in cutaneous malignant melanoma, case fatality deserves more attention in future epidemiologic research than it has received to-date. In this context, a revision of the criteria for histopathological "malignancy" at initial treatment against empirical data on the outcome quoad vitam is warranted.