The global burden of skin cancer: A longitudinal analysis from the Global Burden of Disease Study, 1990-2017

Abstract

Background: Despite efforts toward the earlier detection and prevention of skin cancer, the prevalence of skin cancers continues to increase. Identifying trends in skin cancer burdens among populations can lead to impactful and sustainable interventions.

Methods: We assessed the global trends in skin cancer from 1990 to 2017 in 195 countries worldwide through the Global Burden of Disease Study (GBD) 2017 database.

Results: The rate of change in skin cancers between 1990 to 2017 varied among countries. Squamous cell carcinomas increased by 310% during this time, the highest among any neoplasm tracked by the GBD. Men experienced greater age-specific prevalence rates of keratinocyte carcinoma across all ages (P < .05). Women had a greater prevalence of melanoma until approximately age 50 years, after which the trend reversed until age 85 years. Men experienced greater age-specific death rates across all ages. The disability-adjusted life years (DALYs) of melanoma and keratinocyte carcinoma increased exponentially with age (P < .05).

Conclusion: The incidence, prevalence, and DALYs of skin cancers are increasing disproportionately among different demographic groups. As a worldwide epidemiological assessment, the GBD 2017 provides frequently updated measures of the skin cancer burden, which may help to direct resources and allocate funding to close the gap in global skin cancer disparities.

Keywords: BCC, basal cell carcinomas; DALYs, disability-adjusted life years; Global Burden of Disease Study (GBD) database; KC, keratinocyte carcinoma; SCC, squamous cell carcinomas; SDI, sociodemographic index; UVR, ultraviolet radiation; basal cell carcinoma; disability-adjusted life years (DALYs); melanoma; sociodemographic index (SDI); squamous cell carcinoma.

Fig 1

A, Percent changes in the age-standardized prevalence rate of keratinocyte carcinoma per 100,000 population from 1990 to 2017. The top 10 countries with the largest increases were: China, Trinidad and Tobago, Poland, Canada, Mali, Oman, Lebanon, India, Indonesia, and Portugal. The top 10 countries with the largest decrease were: Zimbabwe, Thailand, Burundi, South Sudan, Algeria, Jordan, Tunisia, Central African Republic, Iran, and Brunei. B, Percent changes in the age-standardized prevalence rate of melanoma per 100,000 population from 1990 to 2017. The top 10 countries with the largest increases were: South Korea, Lebanon, Cyprus, Saudi Arabia, Portugal, Belarus, Romania, Estonia, Singapore, and Latvia. The top 10 countries with the largest decreases were: Burundi, Zambia, Iraq, Burkina Faso, Liberia, Guinea-Bissau, Niger, Mozambique, Cameroon, and Kyrgyzstan.

Fig 2

A, Age patterns by sex of the total number of prevalent cases in 2017 and age-specific prevalence rates of keratinocyte carcinoma at the global level. B, Age patterns by sex of the total number of prevalent cases in 2017 and age-specific prevalence rate of melanoma at the global level. C, Age patterns by sex of the total number of deaths in 2017 and age-specific death rate of melanoma at the global level.

Fig 3

Melanoma and keratinocyte carcinoma disability-adjusted life years per 100,000 population at the global level by age in 2017.

Fig 4

A, Trends in DALYs per 100,000 cases of keratinocyte carcinoma in 7 GBD super regions along with the global value from 1990 to 2017. B, Trends in the DALYs per 100,000 cases of melanoma in 7 GBD super regions along with the global value from 1990 to 2017. DALYs, Disability-adjusted life years; GBD, Global Burden of Disease.

Fig 5

Melanoma and keratinocyte carcinoma disability-adjusted life years per 100,000 population by Global Burden of Disease world regions in 2017.

Fig 6

A, Age-standardized disability-adjusted life years from keratinocyte carcinoma by sociodemographic index for all 195 countries and territories in 2017. Expected values are shown as the black line. ALB, Albania; AB, Antigua and Barbuda; ARG, Argentina; ARM, Armenia; AZE, Azerbaijan; BAH, Bahamas; BEL, Belarus; BER, Bermuda; BH, Bosnia and Herzegovina; BRA, Brazil; COL, Colombia; CR, Costa Rica; CZR, Czech Republic; DOM, Dominica; ECU, Ecuador; EG, Equatorial Guinea; IND, Indonesia; JAM, Jamaica; KYR, Kyrgyzstan; MAC, Macedonia; MOL, Moldova; MON, Montenegro; PAN, Panama; PHI, Philippines; PR, Puerto Rico; RUS, Russian Federation; SEY, Seychelles; SLV, Slovakia; SLO, Slovenia; SL, St. Lucia; SVG, St. Vincent and the Grenadines; SUR, Suriname; THA, Thailand; TUR, Turkmenistan; UAE, United Arab Emirates; UK, United Kingdom; VI, U.S. Virgin Islands; UZB, Uzbekistan; VIE, Vietnam. B, Age-standardized disability-adjusted life years from melanoma by sociodemographic index for all 195 countries and territories in 2017. Expected values are shown as the black line. ALB, Albania; ARM, Armenia; AZE, Azerbaijan; BEL, Belize; CAM, Cameroon; DOM, Dominica; DR, Dominican Republic; ES, El Salvador; EG, Equatorial Guinea; GAB, Gabon; GRE, Grenada; GUA, Guatemala; IND, Indonesia; JAM, Jamaica; KYR, Kyrgyzstan; MAL, Maldives; MAU, Mauritania; MEX, Mexico; MOR, Morocco; MYA, Myanmar; NK, North Korea; PAR, Paraguay; PHI, Philippines; SEY, Seychelles; SUR, Suriname; TAJ, Tajikistan; THA, Thailand; TL, Timor Leste; TUN, Tunisia; TUR, Turkmenistan; UZB, Uzbekistan; VEN, Venezuela; VIE, Vietnam.

Fig 6

A, Age-standardized disability-adjusted life years from keratinocyte carcinoma by sociodemographic index for all 195 countries and territories in 2017. Expected values are shown as the black line. ALB, Albania; AB, Antigua and Barbuda; ARG, Argentina; ARM, Armenia; AZE, Azerbaijan; BAH, Bahamas; BEL, Belarus; BER, Bermuda; BH, Bosnia and Herzegovina; BRA, Brazil; COL, Colombia; CR, Costa Rica; CZR, Czech Republic; DOM, Dominica; ECU, Ecuador; EG, Equatorial Guinea; IND, Indonesia; JAM, Jamaica; KYR, Kyrgyzstan; MAC, Macedonia; MOL, Moldova; MON, Montenegro; PAN, Panama; PHI, Philippines; PR, Puerto Rico; RUS, Russian Federation; SEY, Seychelles; SLV, Slovakia; SLO, Slovenia; SL, St. Lucia; SVG, St. Vincent and the Grenadines; SUR, Suriname; THA, Thailand; TUR, Turkmenistan; UAE, United Arab Emirates; UK, United Kingdom; VI, U.S. Virgin Islands; UZB, Uzbekistan; VIE, Vietnam. B, Age-standardized disability-adjusted life years from melanoma by sociodemographic index for all 195 countries and territories in 2017. Expected values are shown as the black line. ALB, Albania; ARM, Armenia; AZE, Azerbaijan; BEL, Belize; CAM, Cameroon; DOM, Dominica; DR, Dominican Republic; ES, El Salvador; EG, Equatorial Guinea; GAB, Gabon; GRE, Grenada; GUA, Guatemala; IND, Indonesia; JAM, Jamaica; KYR, Kyrgyzstan; MAL, Maldives; MAU, Mauritania; MEX, Mexico; MOR, Morocco; MYA, Myanmar; NK, North Korea; PAR, Paraguay; PHI, Philippines; SEY, Seychelles; SUR, Suriname; TAJ, Tajikistan; THA, Thailand; TL, Timor Leste; TUN, Tunisia; TUR, Turkmenistan; UZB, Uzbekistan; VEN, Venezuela; VIE, Vietnam.