Investigators looking at changes in melanoma cases and death rates, reported in U.S. states and regions between 2003 and 2013, found that these rates varied widely among states — while some saw their numbers decrease, others showed a marked increase.
The research letter, “Comparison of Regional and State Differences in Melanoma Rates in the United States: 2003 vs 2013,” was published in JAMA Dermatology. It attributed this variation both to differences in population and in melanoma awareness programs among states.
Melanoma incidence and mortality data was collected from the United States Cancer Statistics database of the Centers for Disease Control and Prevention (CDC). Prior studies had reported finding a large variance in both parameters due to differences in population demographics among states. Therefore, the researchers further grouped states into four regions: Northeast, South, Midwest, and West.
Complete melanoma incidence rates in the years evaluated were available for 49 states. Of those, 11 (22%) experienced a decrease and 38 (78%) showed an increase in melanoma cases. Broken down into regions, the Northeast showed the biggest drop in melanoma cases between 2003-13, in five out of nine states (56%), while the greatest increase was seen in the South, in 15 of 16 states (94%).
Data on death rates was available for 48 states. Overall, 23 (48%) showed a decrease, four states (8%) had no change, and 21 states (44%) showed an increase in melanoma death rates. Regionally, nine out of 12 Western states (75%) experienced the greatest decrease in mortality, while 10 out of 11 states in the Midwest (91%) showed the greatest increase. Many of the states reporting no change were in the Northeast and South.
According to the CDC, “more than 9 out of 10 cases of melanoma are diagnosed in non-Hispanic whites. Differences in state populations are responsible for much of the variation in melanoma rates between states.”
The researchers suggest more analyses are needed for regional studies. Among the 11 Midwestern states for which data was available, incidence and death rates rose in 73% of them, possibly due to a greater number of cases being reported there.
However, other regions experienced wide variations; for example, the South showed a rise in melanoma cases in 15 of 16 states, but an increase in death rates in seven states, while seven others saw a decrease (both 44%).
While the population demographics may play a role in variation among states and regions, the authors suggest that strong awareness programs also factor in. For example, the researchers attributed the Northeast’s strong decline in new melanoma cases to its more aggressive prevention programs.
