Melanoma mortality in middle-aged and older men, and older women in New Zealand.

An analysis was performed of factors that may contribute to the apparent excess of poor prognosis melanomas of the skin among men > or = 45 and women > or = 60 years of age, who experience 75% of all melanoma deaths in New Zealand. Following the start of a national melanoma awareness campaign, relevant general practice consultations with men > or = 55 increased 2.6-fold (95% CI: 2.1 to 3.6); consultations with men < 45 increased 5.1-fold (4.1 to 6.9). Men > or = 55 tended to have a longer duration of symptoms than men < 55. Age-standardized mortality rates increased consistently in the period from 1949 to 1989. The data suggest a birth cohort-dependent increase in melanoma mortality which appears to involve increased incidence and decreased case fatality rates, and which could explain at least part of the high proportion of lesions with poor prognosis that occur in middle-aged and older men, and older women.