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RESEARCH ARTICLE Open AccessA comparison of trends in melanoma mortality inNew Zealand and Australia: the two countrieswith the highest melanoma incidence andmortality in the worldMary Jane Sneyd * and Brian CoxAbstractBackground: New Zealand and Australia have the highest incidence and mortality rates from cutaneous melanomain the world. The predominantly fair-skinned New Zealanders and Australians both enjoy sun, tanned skin and theoutdoors, and differences in these activities among generations have been important determinants of trends inmelanoma mortality.We examined whether New Zealand trends in melanoma mortality mirror those in Australia, through detailedcomparison of the trends in both countries from 1968 to 2007.Methods: Five-year age-specific and age-standardised mortality rates were calculated for each country for 5-yeartime periods. Tests for trends in age-specific rates were performed using the Mantel-Haenszel extension chi-squaretest. The age-adjusted mortality rate ratios for New Zealand/Australia were plotted against period of death to showrelative changes in mortality over time. Age-specific mortality rates were plotted against period and the medianyear of birth to illustrate age-group and birth cohort effects. To compare the mortality of birth cohorts, age-adjusted melanoma mortality rate ratios were calculated for the birth cohorts in the quin-quennial tables ofmortality rates.Results: The age-standardised mortality rate for melanoma increased in both sexes in New Zealand and Australiafrom 1968 to 2007, but the increase was greater in New Zealanders and women in particular. There was evidenceof recent significant decreases in mortality in younger Australians and less so in New Zealand women aged under45 years. Mortality from melanoma increased in successive generations born from about 1893 to 1918. In Australia,a decline in mortality started for generations born from about 1958 but in New Zealand there is possibly a decreaseonly in generations born since 1968.Conclusions: Mortality trends in New Zealand and Australia are discrepant. It is too early to know if the pattern inmortality rates in New Zealand is simply a delayed response to melanoma control activities compared withAustralia, whereby we can expect the same downward trend in similar age groups in the next few years. Specificresearch is needed to better understand and control the increases in mortality and thickness of melanoma in NewZealand.Keywords: Melanoma, Mortality, Trends* Correspondence: mary-jane.sneyd@otago.ac.nzHugh Adam Cancer Epidemiology Unit, Dunedin School of Medicine,University of Otago, Dunedin, New Zealand© 2013 Sneyd and Cox; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the CreativeCommons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, andreproduction in any medium, provided the original work is properly cited.Sneyd and Cox BMC Cancer 2013, 13:372http://www.biomedcentral.com/1471-2407/13/372