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A comparison of trends in melanoma mortality in New Zealand and Australia: the two countries with the highest melanoma incidence and mortality in the world.

Sneyd MJ, Cox B - BMC Cancer (2013)

Bottom Line: Age-specific mortality rates were plotted against period and the median year of birth to illustrate age-group and birth cohort effects.There was evidence of recent significant decreases in mortality in younger Australians and less so in New Zealand women aged under 45 years.In Australia, a decline in mortality started for generations born from about 1958 but in New Zealand there is possibly a decrease only in generations born since 1968.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: New Zealand and Australia have the highest incidence and mortality rates from cutaneous melanoma in the world. The predominantly fair-skinned New Zealanders and Australians both enjoy sun, tanned skin and the outdoors, and differences in these activities among generations have been important determinants of trends in melanoma mortality.

Methods: Five-year age-specific and age-standardised mortality rates were calculated for each country for 5-year time periods. Tests for trends in age-specific rates were performed using the Mantel-Haenszel extension chi-square test. The age-adjusted mortality rate ratios for New Zealand/Australia were plotted against period of death to show relative changes in mortality over time. Age-specific mortality rates were plotted against period and the median year of birth to illustrate age-group and birth cohort effects. To compare the mortality of birth cohorts, age-adjusted melanoma mortality rate ratios were calculated for the birth cohorts in the quin-quennial tables of mortality rates.

Results: The age-standardised mortality rate for melanoma increased in both sexes in New Zealand and Australia from 1968 to 2007, but the increase was greater in New Zealanders and women in particular. There was evidence of recent significant decreases in mortality in younger Australians and less so in New Zealand women aged under 45 years. Mortality from melanoma increased in successive generations born from about 1893 to 1918. In Australia, a decline in mortality started for generations born from about 1958 but in New Zealand there is possibly a decrease only in generations born since 1968.

Conclusions: Mortality trends in New Zealand and Australia are discrepant. It is too early to know if the pattern in mortality rates in New Zealand is simply a delayed response to melanoma control activities compared with Australia, whereby we can expect the same downward trend in similar age groups in the next few years. Specific research is needed to better understand and control the increases in mortality and thickness of melanoma in New Zealand.

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Contour surfaces of male melanoma mortality for (a) New Zealand and (b) Australia.
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Figure 1: Contour surfaces of male melanoma mortality for (a) New Zealand and (b) Australia.

Mentions: The contour graphs for age, period of death, and melanoma mortality rate for New Zealand and Australian men are shown in Figure 1 and for women in Figure 2. These represent the surface of melanoma mortality for the population during the years 1968–2007 in five-year age groups. The surfaces demonstrate the pronounced increase in mortality since the 1970s, particularly in older age groups, for both men and women in Australia and New Zealand. Melanoma mortality was higher in New Zealand than in Australia in the most recent years, particularly at older ages, for both men and women. The determinants of mortality that govern these surfaces include age effects (increased mortality with age), generational or cohort effects (experiences of risk or protective factors for the lifetime of each generation included), and period effects (for example, changes in risk factors, stage at presentation, melanoma subtype, or treatments that have occurred across all age groups in particular time periods).


A comparison of trends in melanoma mortality in New Zealand and Australia: the two countries with the highest melanoma incidence and mortality in the world.

Sneyd MJ, Cox B - BMC Cancer (2013)

Contour surfaces of male melanoma mortality for (a) New Zealand and (b) Australia.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3750694&req=5

Figure 1: Contour surfaces of male melanoma mortality for (a) New Zealand and (b) Australia.
Mentions: The contour graphs for age, period of death, and melanoma mortality rate for New Zealand and Australian men are shown in Figure 1 and for women in Figure 2. These represent the surface of melanoma mortality for the population during the years 1968–2007 in five-year age groups. The surfaces demonstrate the pronounced increase in mortality since the 1970s, particularly in older age groups, for both men and women in Australia and New Zealand. Melanoma mortality was higher in New Zealand than in Australia in the most recent years, particularly at older ages, for both men and women. The determinants of mortality that govern these surfaces include age effects (increased mortality with age), generational or cohort effects (experiences of risk or protective factors for the lifetime of each generation included), and period effects (for example, changes in risk factors, stage at presentation, melanoma subtype, or treatments that have occurred across all age groups in particular time periods).

Bottom Line: Age-specific mortality rates were plotted against period and the median year of birth to illustrate age-group and birth cohort effects.There was evidence of recent significant decreases in mortality in younger Australians and less so in New Zealand women aged under 45 years.In Australia, a decline in mortality started for generations born from about 1958 but in New Zealand there is possibly a decrease only in generations born since 1968.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: New Zealand and Australia have the highest incidence and mortality rates from cutaneous melanoma in the world. The predominantly fair-skinned New Zealanders and Australians both enjoy sun, tanned skin and the outdoors, and differences in these activities among generations have been important determinants of trends in melanoma mortality.

Methods: Five-year age-specific and age-standardised mortality rates were calculated for each country for 5-year time periods. Tests for trends in age-specific rates were performed using the Mantel-Haenszel extension chi-square test. The age-adjusted mortality rate ratios for New Zealand/Australia were plotted against period of death to show relative changes in mortality over time. Age-specific mortality rates were plotted against period and the median year of birth to illustrate age-group and birth cohort effects. To compare the mortality of birth cohorts, age-adjusted melanoma mortality rate ratios were calculated for the birth cohorts in the quin-quennial tables of mortality rates.

Results: The age-standardised mortality rate for melanoma increased in both sexes in New Zealand and Australia from 1968 to 2007, but the increase was greater in New Zealanders and women in particular. There was evidence of recent significant decreases in mortality in younger Australians and less so in New Zealand women aged under 45 years. Mortality from melanoma increased in successive generations born from about 1893 to 1918. In Australia, a decline in mortality started for generations born from about 1958 but in New Zealand there is possibly a decrease only in generations born since 1968.

Conclusions: Mortality trends in New Zealand and Australia are discrepant. It is too early to know if the pattern in mortality rates in New Zealand is simply a delayed response to melanoma control activities compared with Australia, whereby we can expect the same downward trend in similar age groups in the next few years. Specific research is needed to better understand and control the increases in mortality and thickness of melanoma in New Zealand.

Show MeSH
Related in: MedlinePlus