• E Gutiérrez-González, G López-Abente, N Aragonés, M Pollán, R Pastor-Barriuso, M J Sánchez, and B Pérez-Gómez.
• Public Health & Preventive Medicine Teaching Unit, National School of Public Health, Carlos III Institute of Health, Madrid, Spain.
• J Eur Acad Dermatol Venereol. 2019 Aug 1; 33 (8): 1522-1528.

BackgroundMortality from malignant cutaneous melanoma increased alarmingly during the second half of the 20th century in Spain and other European countries.ObjectiveThe aim was to analyse sex- and age-specific trends in melanoma mortality in Spain in the period 1982-2016.MethodsEuropean age-standardized melanoma mortality rates during the period 1982-2016 were calculated from mortality figures provided by the National Statistics Institute. Joinpoint regressions were used to identify significant points of change in trends and to compute average annual per cent change (AAPC). Age-cohort-period models were fitted to explore the effect of these variables on mortality.ResultsDuring the period 1982-2016, age-standardized melanoma mortality rates increased in Spain from 0.90 to 1.80 deaths per 100 000 people in men and from 0.64 to 1.11 per 100 000 in women, rising noticeably from 1982 to 1995 in both sexes and in all age groups. From the mid-90s different trends were observed depending on sex and age: there was a decrease in mortality in the population younger than 45 years (AAPC -2 in both sexes) and aged 45-64 years (AAPC -1 among men and -0.2 among women), but in the group over 64 years rates continued to increase (AAPC 1.7 and 0.2, respectively, for men and women). The mortality sex ratio decreased in the younger population but increased in older individuals. A cohort effect was observed with lower mortality in the cohorts born after 1943 in men and 1956 in women. There was also a period effect with decreased mortality rates at the beginning of the 1990s.ConclusionsMelanoma mortality rates in Spain increased during the last decades of the 20th century; however, later they stabilized in women and began to decrease in younger cohorts and middle-aged men. Promotion of primary and secondary prevention measures should continue, with particular emphasis on males over 65 years.© 2019 European Academy of Dermatology and Venereology.

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