SCIENTIFIC
Temporal Trends in Melanoma Mortality in West Virginia, 1999-2023
AUTHORS: Madelyn Ross, BS 1 William Snider, BS 1 Ian Depew, BS 1 Emily Saurborn, BS 1 Shane Cook, MD 1
AFFILIATIONS:
1
Marshall University Joan C. Edwards School of Medicine, Department of Dermatology
CORRESPONDING AUTHOR:
Madelyn Ross, BS Ross351 @ marshall. edu
DISCLOSURES: None
IRB STATEMENT:
The Institutional Review Board of Marshall University was notified of this study. Approval was not required as it involved only publicly available, de-identified data obtained from the CDC WONDER database.
FUNDING: None
INTRODUCTION
Melanoma is one of the most serious forms of skin cancer, but it is highly treatable when detected early. Over the past two decades, advances in therapy, increased awareness, and improved early detection have contributed to an overall decline in melanoma mortality across the United States( US). 1 West Virginia( WV) offers interesting prospects for examining melanoma mortality trends. While this study does not directly evaluate the role of rurality, analyzing melanoma mortality in a largely rural population can provide insight into broader patterns of healthcare access and disparities. National data consistently show males experience higher melanoma mortality rates than females, but little is known
ABSTRACT
INTRODUCTION
Melanoma is a significant public health concern in the United States. West Virginia( WV), a largely rural state, may experience distinct trends in mortality from melanoma due to limited dermatologic access and socioeconomic factors.
OBJECTIVE
To examine temporal trends in melanoma mortality in WV from 1999 to 2023 and to evaluate sex-based differences using Joinpoint regression, with comparison to the state of Mississippi( MS).
METHODS
Mortality data was extracted from the CDC WONDER database for males, females, and the overall population of WV( 1999-2023) and MS( 1999-2020). Joinpoint regression was used to calculate annual percent change( APC) and identify inflection points in mortality trends.
RESULTS
about how these differences manifest at the state level, especially in areas facing healthcare barriers. 2 Although national trends indicate a decline in melanoma mortality beginning in the early 2010s, few studies have assessed whether similar patterns are seen at the state level, particularly in underserved rural regions like WV. 1 Additionally, limited data exist on sex-specific mortality trends within these populations. For comparison, Mississippi( MS) was included in the analysis as another largely rural state with similar healthcare access challenges.
The objective of this study was to evaluate melanoma mortality in WV from 1999 to 2023 and to compare these trends with MS from 1999 to 2020, while also assessing sex-specific differences in mortality, using Joinpoint regression analysis.
Overall melanoma mortality in WV declined over the 24-year period. There was a significant decrease beginning around 2013( APC:-3.37 %). Male mortality was consistently higher than female mortality throughout the study period, with male APCs declining after 2012( APC:-3.57 %) while female APCs also declined after 2012 but from a lower peak( APC:-3.79 %). Data from MS revealed a similar pattern of decline but with higher mortality rates overall. Male mortality increased from 1999-2007( APC: + 3.82 %) before declining from 2007-2020( APC: – 2.20 %). Female mortality declined steadily across the entire period( APC:-1.65 %). In both WV and MS, male mortality consistently exceeded female mortality.
CONCLUSIONS
Melanoma mortality declined significantly in both WV( 1999-2023) and MS( 1999-2020). In WV, there was a statistically significant decline beginning in the early 2010s. This finding could be due to national improvements in treatment and early detection. However, persistent sex-based disparities highlight the need for targeted public health interventions in high-risk male populations.
METHODS
Age-adjusted melanoma mortality rates for WV( 1999-2023) and MS( 1999-2020) were obtained from the CDC WONDER database. Rates were reported per 100,000 individuals and standardized to the 2000 US population. Data were stratified by sex and analyzed using Joinpoint regression to identify significant changes in trend direction and calculate the annual percent change( APC). Joinpoint regression identifies points where significant changes in trend occur and estimates the APC for each identified segment. Mortality rates with fewer than 20 deaths were flagged as statistically unreliable but were retained in the dataset to maintain continuity in trend visualization.
RESULTS
Melanoma mortality in WV experienced an overall decline between 1999 and 2023
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