Global, regional, and national trends in the burden of melanoma and non-melanoma skin cancer: insights from the global burden of disease study 1990-2021

Abstract

This study examines global, regional, and national trends in melanoma and non-melanoma skin cancer (NMSC) burden from 1990 to 2021, their socioeconomic associations, and projects future trends. Data was extracted from the Global Burden of Disease (GBD) 2021 database, focusing on malignant melanoma, basal cell carcinoma (BCC), and squamous cell carcinoma (SCC). Joinpoint regression, age-period-cohort modeling, and decomposition analysis were used to assess temporal trends. The Socio-Demographic Index (SDI) was applied to examine the correlation between skin cancer burden and socioeconomic development, and ARIMA models forecasted future trends. The global burden of skin cancers has shown significant growth over the study period, with the age-standardized incidence rate (ASIR) rising globally (Estimated Annual Percentage Change, EAPC = 1.94%) from 1990 to 2021. This increase was particularly pronounced for BCC and SCC, while the melanoma DALYs rate declined (EAPC = -0.67%). In 2021, the most recent year covered, the global incidence of skin cancers was 6.64 million cases, with an ASIR of 77.66 per 100,000 and a disability-adjusted life years (DALYs) burden of 2.89 million cases. Significant geographic disparities were observed, with Australasia and North America reporting the highest ASIR, while middle-SDI regions exhibited rapid increases. Skin cancer incidence is rising globally, driven by demographic changes, increased UV exposure, and improved detection. The burden of melanoma has decreased, which may be related to advances in treatment. Targeted prevention, equitable access to care, and tailored regional strategies are crucial to mitigating the growing impact of skin cancers worldwide.

Keywords: Basal-cell carcinoma; Global burden of disease study; Health inequalities; Melanoma; Squamous-cell carcinoma.

Fig. 1

Global and regional burden of skin cancers in 2021 and trends from 1990 to 2021. (A) Age-standardized incidence rates (ASIR) and age-standardized DALY rates (ASDR) for overall skin cancers, malignant melanoma, basal-cell carcinoma (BCC), and squamous-cell carcinoma (SCC) in 2021 across global and regional levels. (B) Estimated annual percentage changes (EAPC) in ASIR and ASDR for skin cancers from 1990 to 2021 globally and by region. Error bars show 95% uncertainty intervals.

Fig. 2

Global distribution and trends in the burden of overall skin cancers. (A) ASIR of overall skin cancers per 100,000 population in 2021. (B) ASDR of overall skin cancers per 100,000 population in 2021. (C) EAPC in ASIR of overall skin cancers from 1990 to 2021. (D) EAPC in ASDR of overall skin cancers from 1990 to 2021.

Fig. 3

Temporal trends in the burden of skin cancers from 1990 to 2021. (A) ASIR trends of overall skin cancers, malignant melanoma, BCC, and SCC. (B) ASDR trends of overall skin cancers, malignant melanoma, BCC, and SCC.

Fig. 4

Cross-sectional and longitudinal burden of skin cancers in 2021. (A) Number of new cases of malignant melanoma, BCC, and SCC by region. (B) Number of DALYs attributed to malignant melanoma, BCC, and SCC by region. (C) Proportion of incident cases for each skin cancer type (malignant melanoma, BCC, SCC) globally and by region. (D) Proportion of DALY burden for each skin cancer type by region.

Fig. 5

Age-specific incidence, DALYs, and percentage changes in skin cancers. (A) Number of new cases and ASIR of malignant melanoma, BCC, and SCC across different age groups in 2021. (B) Number of DALYs and ASDR across age groups in 2021. (C) Percentage changes in incidence rates of overall skin cancers and individual cancer types from 1990 to 2021. (D) Percentage changes in DALYs rates of overall skin cancers and individual cancer types from 1990 to 2021.

Fig. 6

Correlation between Socio-Demographic Index (SDI) and the burden of skin cancers. (A–D) ASIR of overall skin cancers, malignant melanoma, BCC, and SCC in relation to SDI. (E–H) ASDR of overall skin cancers, malignant melanoma, BCC, and SCC in relation to SDI. Shaded areas indicate 95% CI.

Fig. 7

Factors contributing to the burden of overall skin cancers across SDI quintiles. (A) Contributions of aging, epidemiological changes, and population growth to the number of incident cases of overall skin cancers across SDI quintiles. (B) Contributions of the same factors to the number of DALYs attributed to overall skin cancers across SDI quintiles. The black dots represent the total values for each SDI group.

Fig. 8

Forecast of ASIR and ASPR of skin cancers (1990–2030). Trends in (A) age-standardized incidence rates (ASIR) and (B) age-standardized DALYs rates (ASDR) of skin cancers. Shaded areas indicate the forecast interval for 2022–2030.