Declining mortality rates for nonmelanoma skin cancers in West Germany, 1968-99

BACKGROUND: Mortality analyses based on routine death certification provide a rough guide to the magnitude of nonmelanoma skin cancer (NMSC) mortality. OBJECTIVES: To examine time trends in NMSC mortality over a 32-year period for the territory of West Germany which included a population of about 66 million people. METHODS: We analysed the NMSC skin cancer mortality data (1968-99) from the former West Germany including West Berlin. We calculated the age-specific and age-standardized mortality rates (World Standard Population) and used a Poisson regression to estimate the underlying age, cohort and period effects. RESULTS: The age-standardized mortality rate decreased from 0.56 per 100,000 in 1968 to 0.24 per 100,000 in 1999 among men and from 0.42 per 100,000 in 1968 to 0.11 per 100,000 in 1999 among women. The estimated annual percentage decrease of the age-standardized NMSC skin cancer mortality rate was -2.3%[95% confidence interval (CI) -2.6 to -1.9] among men and -3.5% (95% CI -4.0 to -3.1) among women during the period 1968-99. This decline is mainly due to a rate decrease in people aged 80 years or more. The change in NMSC skin cancer mortality rates was best explained by age, cohort and period effects. CONCLUSIONS: The NMSC mortality in West Germany showed a continuous decrease from 1968 to 1999. The favourable mortality decline by birth cohort in the most recent birth cohort is an indicator of a likely decline in mortality in the future.