Durán-Romero A J, Sendín-Martin M, Conejo-Mir J, Pereyra-Rodriguez J J
Dermatology Department, Hospital Universitario Virgen del Rocío, Sevilla, España.
School of Medicine, Sevilla University, Sevilla, España.
J Eur Acad Dermatol Venereol. 2021 Apr;35(4):884-891. doi: 10.1111/jdv.16983. Epub 2020 Nov 29.
Recent studies suggest that cutaneous melanoma mortality rates in Spain are stabilizing and even decreasing in younger cohorts.
To analyse mortality rates of melanoma from the last 40 years, focusing on changes related with the development of new therapeutic approaches.
Death records and mid-year population data were collected from the National Statistics Institute. By using the direct method, age-standardized mortality rates were calculated for overall population and for each sex and age group. Significant changes in mortality trends were identified by Joinpoint regressions. The independent effects of age, period and cohort (APC) and potential years of life lost (PYLL) due to melanoma were also analysed.
Age-standardized melanoma mortality rates rose in Spain from 0.78 to 2.13 deaths per 100 000 from the first to the last quinquennium of the study (1979-1983 to 2014-2018) for the overall population. After a marked increase until 1995, mortality rates levelled off. Following this stabilization, from 2015 to 2018 there was a decrease in mortality rates for the overall population (average annual per cent change (AAPC): -4.3, not significant), more accused in males over 64 years old (yo). A period effect was observed from the beginning of 21st century, with mortality rates dropping to date.
There is a decrease in melanoma mortality rates from 2015 in all age groups that confirms previous trends in mortality in younger cohorts. Improvement in diagnosis and development of new therapies for advanced melanoma may have a crucial role in this event. Close monitoring of melanoma mortality rates is necessary to confirm these trends.
最近的研究表明，西班牙皮肤黑色素瘤死亡率趋于稳定，在年轻人群中甚至有所下降。
分析过去40年黑色素瘤的死亡率，重点关注与新治疗方法发展相关的变化。
从国家统计局收集死亡记录和年中人口数据。采用直接法计算总体人群以及各性别和年龄组的年龄标准化死亡率。通过Joinpoint回归确定死亡率趋势的显著变化。还分析了年龄、时期和队列（APC）的独立影响以及黑色素瘤导致的潜在寿命损失年数（PYLL）。
在研究的第一个到最后一个五年期（1979 - 1983年至2014 - 2018年），西班牙总体人群的年龄标准化黑色素瘤死亡率从每10万人0.78例死亡上升至2.13例死亡。在1995年之前显著上升之后，死亡率趋于平稳。在此稳定之后，2015年至2018年总体人群死亡率下降（平均年度百分比变化（AAPC）：-4.3，不显著），在64岁以上男性中更为明显。从21世纪初观察到时期效应，死亡率至今一直在下降。
2015年起所有年龄组的黑色素瘤死亡率均有所下降，这证实了年轻人群先前的死亡率趋势。晚期黑色素瘤诊断的改善和新疗法的发展可能在这一事件中起关键作用。有必要密切监测黑色素瘤死亡率以确认这些趋势。
