FIGURE 10 Average Annual Age-Adjusted Incidence and Mortality Rates* by Sex and Race, Pennsylvania Residents,

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1 MELANOMA of the SKIN Data Highlights Average annual ( ) age-adjusted incidence rates for melanoma of the skin among white males and females were 11. and 7., respectively; while among black males and females, the rates were much lower, 1.1 and.5, respectively. It is recognized from other cancer registries that whites have much higher risks compared to population groups with darker skin pigmentation and white males have higher risks than white females. There were 1,55 resident cases of malignant melanoma of the skin diagnosed in 1995 in Pennsylvania. Annual age-adjusted incidence rates for white males and white females have generally increased since Incidence rates for the United States, as published by the National Cancer Institute, also revealed increasing risks between 1973 and Average annual age-specific incidence rates for began rising with the age group White males aged 4 and older consistently had the highest age-specific incidence rates for this five-year period. As observed with incidence, the average annual age-adjusted death rates for were much higher for whites, especially males. There were 375 deaths due to melanoma skin cancer among state residents in 1995, with 371 or 98.9 percent of these deaths occurring among whites. There were no discernible trends in the annual age-adjusted death rates for white males and females during the ten-year period of Almost 92 percent of cases of melanoma of the skin reported to the Pennsylvania Cancer Registry for 1995 were diagnosed during the in situ and local stages. Prevention of most melanoma deaths should be possible through primary prevention, such as decreased exposure to sunlight, and through screening so that earlier diagnoses can permit more effective treatment. FIGURE 1 Average Annual Age-Adjusted Incidence and Mortality Rates* by Sex and Race, Pennsylvania Residents, Incidence Mortality Race/Sex All Cases/Deaths All Males All Females Age-Adjusted Rate Risk Factors Excess exposure to the sun or other ultraviolet radiation sources, especially at an early age. Lack of skin pigmentation. Immediate family history of skin cancer. *per 1, 197 U.S. standard million population. Certain conditions -- dysplastic nevi and xeroderma pigmentosa. Therapeutic immunosuppression. Early Detection The American Cancer Society recommends routine examinations for changes in skin appearance. Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 92

2 Melanoma of the Skin: INCIDENCE TABLE 1-A NUMBER OF CASES AND AGE-ADJUSTED INCIDENCE RATES BY SEX AND RACE, BY YEAR PENNSYLVANIA RESIDENTS, M A L E S F E M A L E S ALL* CASES ALL RACES* WHITE BLACK ALL RACES* WHITE BLACK YEAR NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE , , , , , , , , , * Includes any unknowns. NOTE: Age-adjusted rates are per 1, and are computed by the direct method using the 197 U.S. standard million population. See technical notes. FIGURE 1-A AGE-ADJUSTED INCIDENCE RATES BY SEX AND RACE PENNSYLVANIA RESIDENTS, RATE PER 1, YEAR Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 93

3 Melanoma of the Skin: INCIDENCE TABLE 1-B AVERAGE ANNUAL AGE-SPECIFIC INCIDENCE RATES BY SEX AND RACE M A L E S F E M A L E S AGE ALL GROUP CASES ALL RACES WHITE BLACK ALL RACES WHITE BLACK Total Under NOTE: Rates are per 1, population ( ) for each specified group. FIGURE 1-B AVERAGE ANNUAL AGE-SPECIFIC INCIDENCE RATES BY SEX AND RACE 6 4 RATE PER 1, 2 Under AGE GROUP 85+ Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 94

4 Melanoma of the Skin: INCIDENCE TABLE 1-C TOTAL NUMBER OF CASES BY AGE, SEX AND RACE M A L E S F E M A L E S AGE ALL* GROUP CASES ALL RACES* WHITE BLACK ALL RACES* WHITE BLACK Total 6,319 3,59 3, ,729 2,66 2 Under * Includes any unknowns. FIGURE 1-C STAGE OF DISEASE AT DIAGNOSIS, PERCENT BY SEX AND RACE PENNSYLVANIA RESIDENTS, In Situ Local Regional Distant PERCENT NUMBER AND PERCENT OF CASES MICROSCOPICALLY CONFIRMED: 1, % Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 95

5 Melanoma of the Skin: MORTALITY TABLE 1-D NUMBER OF DEATHS AND AGE-ADJUSTED DEATH RATES BY SEX AND RACE, BY YEAR PENNSYLVANIA RESIDENTS, M A L E S F E M A L E S ALL* DEATHS ALL RACES* WHITE BLACK ALL RACES* WHITE BLACK YEAR NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE * Includes any unknowns. NOTE: Age-adjusted rates are per 1, and are computed by the direct method using the 197 U.S. standard million population. See technical notes. FIGURE 1-D AGE-ADJUSTED DEATH RATES BY SEX AND RACE PENNSYLVANIA RESIDENTS, RATE PER 1, YEAR Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 96

6 Melanoma of the Skin: MORTALITY TABLE 1-E NUMBER OF DEATHS AND AVERAGE ANNUAL AGE-SPECIFIC DEATH RATES BY SEX AND RACE M A L E S F E M A L E S ALL* AGE DEATHS ALL RACES* WHITE BLACK ALL RACES* WHITE BLACK GROUP NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE NO. RATE TOTAL* 1, , , UNDER * Includes any unknowns. NOTE: Rates are per 1, population ( ) for each specified group. FIGURE 1-E AVERAGE ANNUAL AGE-SPECIFIC DEATH RATES BY SEX AND RACE 3 2 RATE PER 1, 1 UNDER AGE GROUP Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 97

7 Melanoma of the Skin: INCIDENCE TABLE 1-F TOTAL NUMBER OF CASES AND AVERAGE ANNUAL AGE-ADJUSTED INCIDENCE RATES* BY COUNTY AND SEX M A L E S F E M A L E S M A L E S F E M A L E S TOTAL TOTAL COUNTY CASES NO. RATE NO. RATE COUNTY CASES NO. RATE NO. RATE ALL COUNTIES 6,319 3, , ADAMS JUNIATA ALLEGHENY LACKAWANNA ARMSTRONG LANCASTER BEAVER LAWRENCE BEDFORD LEBANON BERKS LEHIGH BLAIR LUZERNE BRADFORD LYCOMING BUCKS MCKEAN BUTLER MERCER CAMBRIA MIFFLIN CAMERON MONROE CARBON MONTGOMERY CENTRE MONTOUR CHESTER NORTHAMPTON CLARION NORTHUMBERLAND CLEARFIELD PERRY CLINTON PHILADELPHIA COLUMBIA PIKE CRAWFORD POTTER CUMBERLAND SCHUYLKILL DAUPHIN SNYDER DELAWARE SOMERSET ELK SULLIVAN ERIE SUSQUEHANNA FAYETTE TIOGA FOREST UNION FRANKLIN VENANGO FULTON WARREN GREENE WASHINGTON HUNTINGDON WAYNE INDIANA WESTMORELAND JEFFERSON WYOMING YORK * Age-adjusted rates are per 1, and are computed by the direct method using the 197 U.S. standard million population. See technical notes regarding reliability of rates. Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 98

8 Melanoma of the Skin: MORTALITY TABLE 1-G TOTAL NUMBER OF DEATHS AND AVERAGE ANNUAL AGE-ADJUSTED DEATH RATES* BY COUNTY AND SEX M A L E S F E M A L E S M A L E S F E M A L E S TOTAL TOTAL COUNTY DEATHS NO. RATE NO. RATE COUNTY DEATHS NO. RATE NO. RATE ALL COUNTIES 1,79 1, ADAMS JUNIATA ALLEGHENY LACKAWANNA ARMSTRONG LANCASTER BEAVER LAWRENCE BEDFORD LEBANON BERKS LEHIGH BLAIR LUZERNE BRADFORD LYCOMING BUCKS MCKEAN BUTLER MERCER CAMBRIA MIFFLIN CAMERON MONROE CARBON MONTGOMERY CENTRE MONTOUR CHESTER NORTHAMPTON CLARION NORTHUMBERLAND CLEARFIELD PERRY CLINTON PHILADELPHIA COLUMBIA PIKE CRAWFORD POTTER CUMBERLAND SCHUYLKILL DAUPHIN SNYDER DELAWARE SOMERSET ELK SULLIVAN ERIE SUSQUEHANNA FAYETTE TIOGA FOREST UNION FRANKLIN VENANGO FULTON WARREN GREENE WASHINGTON HUNTINGDON WAYNE INDIANA WESTMORELAND JEFFERSON WYOMING YORK * Age-adjusted rates are per 1, and are computed by the direct method using the 197 U.S. standard million population. See technical notes regarding reliability of rates. Pennsylvania Department of Health - Pennsylvania Cancer Incidence and Mortality Page 99