# Trends and disparities in skin malignant neoplasm mortality in the United States: a 22-year trend analysis based on CDC WONDER Data (1999-2020)

## TL;DR

This study analyzed 22 years of data to show how skin cancer deaths in the US have changed over time and highlight differences across demographics and regions.

## Contribution

The study provides a comprehensive analysis of skin cancer mortality trends and disparities in the US from 1999 to 2020 using CDC data.

## Key findings

- Skin cancer mortality rates increased until 2014, then declined significantly until 2017, and stabilized afterward.
- Men had higher mortality rates than women, and older adults (65+) had the highest rates.
- White people had much higher mortality rates than Black or Hispanic populations, and rural areas had higher rates than urban areas.

## Abstract

Skin malignant neoplasms are common malignancies worldwide, with epidemiological characteristics showing significant geographical and demographic disparities. This study aims to comprehensively analyze the temporal trends and demographic disparities in skin malignant neoplasm mortality among US adults from 1999 to 2020 using the CDC WONDER database.

Mortality data for skin malignant neoplasms (ICD-10: C43-C44) among US adults (≥25 years) from 1999 to 2020 were obtained from the CDC’s WONDER online database. Joinpoint regression analysis was used to evaluate temporal trends in age-adjusted mortality rates (AAMR), calculating annual percent change (APC) and average annual percent change (AAPC). Stratified analyses were conducted by sex, age group, race/ethnicity, geographic region, and rural-urban status.

Between 1999 and 2020, a total of 251,848 skin malignant neoplasm deaths were reported in the United States, with an age-adjusted mortality rate of 5.299 per 100,000 person-years. Male mortality rates (8.137 per 100,000) were significantly higher than female rates (3.157 per 100,000). The overall mortality rate showed an increasing trend from 1999 to 2014 (APC =+ 0.271%), followed by a significant decrease from 2014 to 2017 (APC=-5.292%), and remained stable from 2017 to 2020 (APC=-0.563%).Age group analysis revealed that adults aged 65 and older had the highest mortality rate (17.902 per 100,000). Regarding racial disparities, white people had significantly higher mortality rates (5.996 per 100,000) compared to Black or African American(1.291 per 100,000) and Hispanic or Latino(1.018 per 100,000). Geographically, the Southern region had the highest mortality rate (5.452 per 100,000), and rural areas (5.960 per 100,000) had higher rates than metropolitan areas (5.160 per 100,000). State-level analysis showed that Idaho, Oklahoma, West Virginia, Kentucky, and Delaware ranked highest in mortality rates nationwide.

Skin malignant neoplasm mortality in the United States shows an overall declining trend, but significant disparities exist across demographic characteristics and geographic regions. These findings provide important evidence for developing targeted prevention strategies and resource allocation for high-risk populations. Future research should further explore potential factors behind these disparities, including socioeconomic factors, healthcare accessibility, and environmental exposures.