Although the recent drop in melanoma mortality has been attributed to the introduction of newer therapies, the impact of ongoing public efforts remains unknown. Characterize and model melanoma mortality trends before the era of molecular and immune therapies (1969-2014) in the U.S. and Australia. Differential time series analysis based on population-ascertained melanoma mortality rates from the U.S. and Australia. Mortality rates were modeled and compared to the trajectories of ten other cancers. Melanoma mortality rates have been significantly decelerating since the 1970s in both the U.S. ( < .0001) and Australia ( = .0021). Zero acceleration occurred around 2001 (95% CI: 1996, 2008) for the U.S. and 2004 (95% CI: 1999, 2011) for Australia. Male mortality rates decelerated 3x-4x faster than females in both countries. Melanoma mortality followed a similar quadratic function (R > 0.9) to 10 other cancers, albeit with a later inflection point (1986 vs 2001) and broader focal width. Absolute mortality data used without further stratification or considering cancer incidence or covariates. Melanoma deaths have been decelerating for the past 5 decades, reaching an inflection point around 2001, suggesting that mitigating campaigns were already afoot in both the U.S. and Australia before the advent of modern therapies.

中文翻译：

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差异时间序列分析显示，在广泛使用高效疗法之前，黑色素瘤死亡率下降


尽管最近黑色素瘤死亡率的下降归因于新疗法的引入，但公众持续努力的影响仍然未知。描述美国和澳大利亚分子和免疫疗法时代（1969-2014）之前的黑色素瘤死亡率趋势并对其进行建模。基于美国和澳大利亚人口确定的黑色素瘤死亡率的差异时间序列分析。对死亡率进行了建模，并与其他十种癌症的轨迹进行了比较。自 20 世纪 70 年代以来，美国 (< .0001) 和澳大利亚 (= .0021) 的黑色素瘤死亡率显着下降。美国的零加速度发生在 2001 年左右（95% CI：1996、2008 年），澳大利亚则发生在 2004 年（95% CI：1999、2011 年）。这两个国家的男性死亡率下降速度比女性快 3 至 4 倍。黑色素瘤死亡率与其他 10 种癌症遵循类似的二次函数 (R > 0.9)，尽管拐点较晚（1986 年与 2001 年）且焦点宽度更宽。使用绝对死亡率数据，无需进一步分层或考虑癌症发病率或协变量。过去 5 年来，黑色素瘤死亡人数一直在下降，在 2001 年左右达到了拐点，这表明在现代疗法出现之前，美国和澳大利亚就已经开展了缓解运动。