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Melanoma mortality decline, education linked among non-Hispanic whites

Declines in melanoma mortality rates among non-Hispanic white men and women were largely confined to the more-educated population, according to recent study results.

In a descriptive study across 26 states, researchers reviewed 21,230 death certificates for individuals aged 25 to 64 years, representing 44.8% of the US melanoma deaths for that subgroup during 1993-2007. They also examined recorded educational levels and population data from the US Bureau of Census Current Population Survey.

Based on the CDC’s National Center for Health Statistics standards, educational levels were categorized as: less than 12 years (did not finish high school), 12 years (high school graduate) and 13 or more years (had some college education or higher). Researchers limited their analysis to non-Hispanic white men and women because this subgroup accounts for more than 97% of melanoma deaths nationally. They also focused on individuals aged 25 to 64 years, generally considered a posteducation period that serves as an indicator of socioeconomic status (SES). The regression-based Relative Index of Inequality (RII) was used to measure mortality differentials in educational levels.

Overall mortality rates declined significantly in men (Rate Ratio=0.916; 95%, CI, 0.878-0.954) and women (RR=0.907; 95% CI 0.857-0.957) during 1993-1997 and 2003-2007. These declines were observed primarily for the population with 13 years or more of education and were statistically significant for men (RR=0.850; 95% CI, 0.797-0.903) and women (RR=0.906; 95% CI, 0.827-0.984). Melanoma mortality rates among the least-educated groups (less than 12 years of education) showed nonsignificant increases (P=.17 for men; P=.33 for women). The RII for melanoma mortality (95% CI) widened by 51.7% in men and by 35.7% in women during 2003-2007 compared with baseline values during 1993-1997.

“An increasingly disproportionate burden of fatal melanoma among low SES populations calls for more vigilant primary and secondary prevention education campaigns directed to high-risk, low SES individuals and the physicians who care for them,” researchers said. “For the control of melanoma, early recognition is the best means to ensure a favorable prognosis.”