Trends in Mortality of Adults with Melanoma in the United States SEER Population

Background: While death from melanoma of the skin has been gradually decreasing over the past few decades, melanoma continues to be the leading causes of death among skin cancers. Less is known about specific causes of mortality among patients with melanoma and how or whether trends in cause of death among patients diagnosed with melanoma have changed in recent years. Objective: To examine temporal trends in the cause-specific mortality among adult patients diagnosed with melanoma in the US between 2000-2013. Methods: US patients ≥ 45 years when diagnosed with melanoma were identified using data from the Surveillance, Epidemiology, and End Results Program, 18 Registries (SEER-18). Joinpoint regression analysis was used to examine the trends in cause-specific mortality among patients who were diagnosed with melanoma and died from either melanoma or other causes of death. Trends were also examined separately by age, sex, and geographic region. Results: A total of 52,675 patients diagnosed with melanoma who died from either melanoma or other cause of death (median age 74 years, 67% male) were included in the analysis. Overall, 31% of deaths were due to melanoma specifically, whereas 69% died from various other causes. A marked decline in melanoma-specific mortality was observed overall and across strata by age, sex, and region in the US beginning around 2013-2014. Among all causes of death, 55% were due to melanoma within 1 year after diagnosis and declined to 25% over the course of 6 years. A marked decline of at least 2.5% in mortality per year from other causes was observed among females, males, those 65 – 74 years or 75 years and older, and those living in northeastern, midwestern, western, and southern regions of US who were diagnosed with melanoma. Conclusions: Changes in cause-specific mortality rate among patients with melanoma were observed overall and across different subgroups. Our findings show that, among those diagnosed with melanoma, the risk of melanoma-specific death is decreasing within the last two decades, and that the deaths among those with melanoma are more likely to be from other causes such as heart disease, lung cancer, and other conditions. Future studies are needed to assess the trends in melanoma mortality as treatments and diagnostic methods continue to advance