Skin cancer mortality in Spain: adjusted mortality rates by province and related risk factors

Background:Ultraviolet radiation is the main environmental risk factor responsible for thedevelopment of skin cancer. Other occupational, socioeconomic, and environmental factorsappear to be related to the risk of skin cancer. Furthermore, the factors appear to differ formelanoma and non-melanoma skin cancer (NMSC). The purpose of this study is toanalyze mortality rates of skin cancer in the different provinces of Spain and to determinethe influence of socioeconomic conditions and other environmental and demographicfactors in rates.MethodsDeaths from melanoma and NMSC in the period 2000–2019 were obtained aswell as socioeconomic and environmental variables. Annual standardized mortality rates(SMR) were calculated for all Spanish provinces. The Pearson correlation coefficient wascalculated.ResultsThe SMR of melanoma was 2.10/100,000 inhabitants, while that of NMSC was1.28/100,000. At the provincial level, a great variability is confirmed. Gross domesticproduct showed a positive correlation with melanoma mortality but a negative correlationwith NMSC. Other environmental and socioeconomic variables also showed correlation, asa positive correlation between tobacco sales and melanoma and between agriculturaldevelopment and the NMSC.ConclusionsThere are still important differences between each province that must betaken into account when planning health care and resource distribution. This ecologicaland province-wise study helps to elucidate the relationship between social and ambientexposure determinants and skin cancer mortality in Spain