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Comparative Study
. 2013 Aug 6:13:372.
doi: 10.1186/1471-2407-13-372.

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

Mary Jane Sneyd, Brian Cox
Comparative Study

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

Mary Jane Sneyd et al. BMC Cancer. .

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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Figures

Figure 1
Figure 1
Contour surfaces of male melanoma mortality for (a) New Zealand and (b) Australia.
Figure 2
Figure 2
Contour surfaces of female melanoma mortality for (a) New Zealand and (b) Australia.
Figure 3
Figure 3
Rate ratios for age-standardised melanoma mortality: New Zealand/Australia. The line of equal mortality rates (rate ratio = 1) is marked.
Figure 4
Figure 4
Trends over time in melanoma mortality for New Zealand and Australian men by age group. (y-axis on log scale).
Figure 5
Figure 5
Trends over time in melanoma mortality for New Zealand and Australian women by age group. (y-axis on log scale).
Figure 6
Figure 6
New Zealand melanoma mortality by 5-year age group and median year of birth. Both sexes combined. (y-axis on log scale).
Figure 7
Figure 7
Australian melanoma mortality by 5-year age group and median year of birth. Both sexes combined. (y-axis on log scale).
See this image and copyright information in PMC

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