Background and design: Nonmelanoma skin cancer is the most common malignancy in the United States. Despite its importance, patterns of mortality from this cause are poorly documented. Recent insights into sources of misclassification allow for more accurate estimation of these patterns. This investigation describes nonmelanoma skin cancer mortality in the United States during 1969 through 1988 on the basis of routine death certification and adjusts reported mortality data for two major sources of misclassification.
Results: Nonmelanoma skin cancer mortality rates decreased by approximately 20% to 30% for both men and women and for both whites and blacks, although the decline among blacks was less consistent than among whites. Mortality was greater among men than among women and greater among whites than among blacks, although the most pronounced difference was between white men and the other three racial/gender groups studied. Approximately 1200 deaths per year are attributable to nonmelanoma skin cancer.
Conclusions: Nonmelanoma skin cancer mortality is diminishing despite increasing incidence. Mortality rates among blacks are extraordinarily high in comparison with their incidence rates. More careful attention to misclassification in mortality statistics is crucial for an accurate assessment of the public health burden of nonmelanoma skin cancer.