Melanoma mortality in Brazil, 1996-2023: A 28-year population-based analysis.

BACKGROUND: Cutaneous melanoma is the most lethal skin cancer and its mortality reflects both biological aggressiveness and inequalities in prevention, early diagnosis, and access to specialized care. In Brazil, long-term population-based analyses are needed to characterize temporal, regional, and sociodemographic patterns of melanoma mortality. OBJECTIVE: To analyze temporal and regional trends in melanoma mortality in Brazil from 1996 to 2023. METHODS: Deaths from melanoma (ICD-10: C43) recorded between 1996 and 2023 were obtained from the Brazilian Mortality Information System. Crude and age-standardized mortality rates were calculated per 100,000 inhabitants. Temporal trends were evaluated using Prais-Winsten regression, with estimation of annual percent change (APC). Complementary Joinpoint regression and age-period-cohort analyses were performed. Mortality odds were estimated using odds ratios. A 5% significance level was adopted for all analyses. RESULTS: A total of 39,608 melanoma-related deaths were recorded. The mean age-standardized mortality rate was 0.68 per 100,000 inhabitants, with a stable overall trend. Deaths predominated among men (57.30%). Joinpoint analysis showed an initial increase in overall mortality from 1996 to 2005, followed by a decrease from 2005 to 2023, although the average annual percent change for the full period was not significant. Mortality increased among individuals aged 80 years or older, Indigenous populations, and individuals with lower educational attainment. The North, Northeast, and Central-West regions showed increasing trends, whereas the Southeast showed a decreasing trend. Age-period-cohort analysis suggested declining mortality in younger and intermediate age groups and possible attenuation of cohort effects in more recent generations. CONCLUSION: Melanoma mortality in Brazil remained stable overall, but with marked age, social, and regional inequalities. These findings support regionally tailored prevention, early diagnosis, improved health information quality, and equitable access to specialized oncologic care.