10 Disease Surveillance Indicators Melanoma Incidence and Mortality Health care providers and pathologists who diagnose or treat melanomas are required to report cases to a central cancer registry in all 50 states, the District of Columbia, and Puerto Rico. These melanoma surveillance data allow for long-term evaluation of skin cancer prevention efforts. Because melanomas often develop after years of exposure to UV radiation, it will likely be several decades before melanoma incidence rates reflect the effects of current prevention efforts. Table 3 shows invasive melanoma incidence rates by sex and race/ethnicity. The highest rates are among non- Hispanic white men (33.8 per 100,000) and lowest are among black individuals (1.0 per 100,000) and Asian/Pacific Islanders (1.4 per 100,000). Non-Hispanic white men also have the highest death rates (4.8 per 100,000; Table 4). Among both men and women, incidence rates have continued to increase over time (Figure 1), and the gender gap in overall melanoma incidence and death rates has persisted (Figures 1 and 2). Figure 3 shows recent trends in melanoma incidence rates among non-Hispanic white individuals aged 15 years or older, by sex and age group during 2006–2015. The recent declines in melanoma incidence rates among non-Hispanic white individuals under the age of 35 years contrast the steady increases observed among older age groups. Table 3. Invasive Melanoma Incidence, by Sex and Race/Ethnicity, United States, 2011–2015a Race/Ethnicity US Population Male Female Rate Average Annual Count Rate Average Annual Count Rate Average Annual Count All Races 21.2 74,175 27.2 43,675 16.8 30,500 White 24.1 70,000 30.5 41,477 19.4 28,523 White, Hispanic b 4.5 1,496 4.9 680 4.4 817 White, non-Hispanic b 27.0 68,499 33.8 40,794 22.0 27,705 Black 1.0 371 1.1 176 0.9 195 American Indian/Alaska Native 5.4 175 6.8 95 4.4 80 Asian/Pacific Islander 1.4 233 1.5 114 1.2 119 Hispanic b 4.5 1,619 4.8 734 4.4 885 Source: United States Cancer Statistics 2001-2015 Public Use Research Database. 13 a Data are from population areas that meet United States Cancer Statistics publication criteria for 2011–2015 and cover about 99.1% of the US population. Rates are per 100,000 population and are age-adjusted to the 2000 US Standard Population. b Race and ethnicity are not mutually exclusive. Counts may not always sum to the total because of rounding and because cases with other and unknown race are included in totals.