FIGURE 1: Age-Adjusted Mortality by Sex in West Virginia, 1999-2023
Age-Adjusted Mortality Rate Per 100,000
5
4
3
2
1
Overall-1 Joinpoint 1999.0-2013.0 APC = 0.29 2013.0-2023.0 APC =-3.37*
Male-1 Joinpoint 1999.0-2012.0 APC = 1.14 2012.0-2023.0 APC =-3.79*
Female-0 Joinpoints 1999.0-2023.0 APC =-1.26*
2001
2004 2007 2010 2013 2016 2019 2021 Year
Annual age-adjusted mortality rates( per 100,000 population) for melanoma in WV over a 24-year period. Rates are standardized to the 2000 US population and include data for the total population, with separate trend lines for males and females.
Group
TABLE 1: Annual percent change( APC), Lower confidence limit( LCL), and Upper confidence limit( UCL)
Segment Start
Segment End
APC APC 95 % LCL
APC 95 % UCL
P-Value
Overall 2013 2023-3.3733-5.7623-0.9237 0.010135
Male 2012 2023-3.792-6.5997-0.8999 0.01356 Female 1999 2023-1.2618-2.3181-0.1941 0.022982
Joinpoint regression analysis of melanoma mortality trends in WV, stratified by sex and time interval, with APC and statistical significance.
( Figure 1). A shift in trend was observed around 2012 – 2013. Before this period, mortality rates remained relatively stable. Following this inflection point, a steady decline was observed, with an overall APC of-3.37 %( p = 0.01356, 95 % CI)( Table 1). For the full study period from 1999 to 2023, the overall APC was-1.67 %( p = 0.02298, 95 % CI)( Table 1).
Stratification by sex revealed males consistently experienced higher melanoma mortality than females throughout the study period. Male mortality peaked around 2012 and subsequently declined at an APC of-3.79 %. Female mortality also decreased during this period, with an APC of-1.26 %, though from a lower baseline. Despite parallel improvements, the absolute difference in mortality between males and females persisted across the entire timeframe.
When compared with MS, WV had a slightly greater overall decline in melanoma mortality( Figure 1 and Figure 2). MS experienced a stable trend until approximately
2015, followed by a statistically significant decrease through 2020, with an APC of-6.18 %( p = 0.003199, 95 % CI)( Table 2). Males consistently had higher mortality than females in both states throughout their respective study periods.
These results show positive progress in melanoma outcomes in WV and MS, while also highlighting the need for continued efforts in early detection and access to dermatologic care in rural populations.
DISCUSSION
This analysis of melanoma mortality in WV from 1999 to 2023 reveals a decline in overall mortality rates. However, it also indicates an obvious inflection point occurring around 2012 – 2013. A similar pattern was observed in MS, where mortality remained stable until 2015 before beginning to decline. These patterns are consistent with national trends. A recent analysis of CDC WONDER data from 1999 to 2020 demonstrated a nationwide decline in melanoma mortality from 2.7 to 2.0 per 100,000 people, with the greatest reductions occurring after 2013. 1
West Virginia Medical Journal • June 2026 • 13