gms | German Medical Science

53. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie e. V. (GMDS)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie

15. bis 18.09.2008, Stuttgart

Skin Cancer Mortality in Germany before and after the Post-Communist Transition: Still higher Non-melanoma Rates in East than in West Germany

Meeting Abstract

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  • Andreas Stang - Universität Halle, Halle, Deutschland
  • Thomas Lampert - Department of Epidemiology and Health Reporting, Robert-Koch-Institute, Berlin, Deutschland
  • Thomas Uhlemann - Wissenschaftliches Institut der AOK (WIdO), Bonn, Deutschland
  • Pietro Trocchi - Universität Halle, Halle, Deutschland

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. 53. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds). Stuttgart, 15.-19.09.2008. Düsseldorf: German Medical Science GMS Publishing House; 2008. DocEPI1-2

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/gmds2008/08gmds002.shtml

Veröffentlicht: 10. September 2008

© 2008 Stang et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielf&aauml;ltigt, verbreitet und &oauml;ffentlich zug&aauml;nglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Background

Until now mortality trends of melanoma and non-melanoma skin cancer in Germany have been studied only in West Germany [1], [2]. We were interested in comparing mortality trends of melanoma and non-melanoma skin cancer in West and East Germany before and after the post-communist transition. By analyses of health care utilization data in West and East Germany we explored potential reasons for mortality differences between West and East Germany.

Methods

We analyzed mortality data of skin melanoma and non-melanoma skin cancer (NMSC) of West Germany and East Germany (1980-2005). We calculated sex-specific age-standardized mortality rates and standard errors (SE) using the World Standard Population. We calculated age-specific mortality rates (20-39, 40-59, 60-79, 80+ years).

Results

Age-standardized skin melanoma mortality rates tended to be lower in East Germany than West Germany before the reunification. After reunification rates became very similar. However, age-standardized mortality rates of non-melanoma skin cancer were continuously higher in East than West Germany. The crude mortality rates of the period 1996-2005 were 5,15 (SE 0,13) and 8,77 (SE 0,36) per million among West and East German men and 4,53 (SE 0,12) and 8,86 (SE 0,35) among West and East German women respectively. The mortality rate differences among East Germans and West Germans in 1996-2005 are mainly due to 2,34-fold and 2,24-fold higher mortality rates among men and women aged 80+ years respectively who live in East Germany. Mortality time trends of NMSC by Federal State showed decreasing trends with the exception of Baden-Württemberg and Niedersachsen, which showed increasing time trends. According to the German National Telephone Health Survey, the percentage of men (45+ years) in West and East Germany who ever underwent an examination for early cancer detection was 66,1% and 50,9% respectively. Among women, the corresponding percentages were 84,5% and 76,5% respectively. Percentages in West Germany were higher across all age groups studied among both men and women. Number of contacts with private practitioners per 100.000 AOK insured people in West and East Germany in 2005 were especially lower in the elderly East Germans aged 70 years and more (East Germany: men 167 per 100.000, women 165 per 100.000; West Germany: men 178 per 100.000, women 180 per 100.000).

Conclusions

Even 15 years after reunification of West and East Germany the mortality of non-melanoma skin cancer, a cancer of the elderly, is still higher in East than West Germany although incidence rates of squamous cell cancers of the skin are not higher in East Germany. Baden-Württemberg and Niedersachsen showed increasing NMSC mortality time trends whereas all other Federal States showed decreasing or constant time patterns. Skin cancer mortality data of the Federal State of Bremen are biased due to a death certificate coding errors (personal communication with Klaus Giersiepen). Differences in the participation in early cancer detection examinations in West and East Germany and less private practitioner contacts may explain our findings.


References

1.
Stang A, Jöckel KH. Changing patterns of skin melanoma mortality in West Germany from 1968 through 1999. Ann Epidemiol 2003; 13: 436-42.
2.
Stang A, Jöckel KH. Declining mortality rates for nonmelanoma skin cancers in West Germany, 1968-99. Br J Dermatol 2004; 150: 517-22.