Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 May 4:8:2050312120918285.
doi: 10.1177/2050312120918285. eCollection 2020.

Spatial clusters and temporal trends of malignant melanoma mortality in Ecuador

Solange Núñez-González  1 , Estefania Bedoya  1 , Daniel Simancas-Racines  1 , Christopher Gault  1
Affiliations

Spatial clusters and temporal trends of malignant melanoma mortality in Ecuador

Solange Núñez-González et al. SAGE Open Med. .

Abstract

Objective: The aim of this study is two fold. First, it describes the temporal trends of malignant melanoma mortality from 2000 to 2016 in Ecuador. Second, it analyzes the spatial clusters of high mortality rates due to malignant melanoma in the country, from 2011 to 2016.

Methods: This is an ecological study; we included all death certificates of malignant melanoma from the National Institute of Statistics and Census database in Ecuador from 2000 to 2016. We calculated crude mortality rates and age-standardized mortality rates, all rates are expressed as deaths per 100,000 population. In order to assess the trend of malignant melanoma rates, we obtained average annual percent changes through Joinpoint regression analysis. Spatial scan statistics were used to identify high-risk clusters and the spatial autocorrelation was evaluated through a global Moran index.

Results: In Ecuador, between 2000 and 2016, malignant melanoma caused a total of 958 deaths. Crude mortality rates increased significantly (annual percent change = 4.8%; 95% confidence interval: 2.6-7.0), the age-standardized mortality rate also increased (annual percent change: 2.9%; 95% confidence interval: 0.5-5.4). The most likely cluster included 19 cantons and the second most likely cluster included 10 cantons, located in the Highlands region. The Global Moran I index for the study period shows a positive spatial autocorrelation (0.32; p = 0.001).

Conclusion: Mortality due to malignant melanoma in Ecuador significantly increased over the 17-year study period; the spatial analysis and spatial autocorrelation indicates the presence of high-risk occurrence clusters in the Highlands region of the country.

Keywords: Ecuador; Latin America; Melanoma; jointpoint; mortality; spatial analysis.

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Trends of the crude mortality rate (CMR) and the age-standardized mortality rate (ASMR) per 100,000 population for malignant melanoma in Ecuador, 2000–2016.
Figure 2.
Figure 2.
Joinpoint Analysis by sex: (a) crude mortality rate (CMR) per 100,000 population for malignant melanoma in Ecuador, 2000–2016 and (b) age-standardized mortality rate (ASMR) per 100,000 population for malignant melanoma in Ecuador, 2000–2016.
Figure 3.
Figure 3.
Spatial analysis of malignant melanoma mortality by cantons in Ecuador, 2011–2016.
Figure 4.
Figure 4.
Local Index of Spatial Association (LISA) cluster analysis of malignant melanoma mortality by cantons in Ecuador, 2011–2016.
See this image and copyright information in PMC

References

    1. World Health Organization (WHO). Skin cancers: how commmon is skin cancer. https://www.who.int/uv/faq/skincancer/en/index1.html (2017, accessed 11 July 2018).
    1. Fitzmaurice C, Allen C, Barber RM, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the Global Burden of Disease Study. JAMA Oncol 2017; 3(4): 524–548. - PMC - PubMed
    1. Naghavi M, Abajobir AA, Abbafati C, et al. Global, regional, and national age-sex specific mortality for 264 causes of death, 1980–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet 2017; 390(10100): 1151–1210. - PMC - PubMed
    1. Karimkhani C, Green AC, Nijsten T, et al. The global burden of melanoma: results from the Global Burden of Disease Study 2015. Br J Dermatol 2017; 177(1): 134–140. - PMC - PubMed
    1. Rastrelli M, Tropea S, Rossi CR, et al. Melanoma: epidemiology, risk factors, pathogenesis, diagnosis and classification. In Vivo 2014; 28(6): 1005–1011. - PubMed

LinkOut - more resources