Skin Cancer Burden Highest in Older Men, Rich Countries
In 2021, skin cancer affected millions of older adults globally. Basal cell carcinoma (BCC) had the highest incidence, while squamous cell carcinoma (SCC) accounted for the greatest disability burden, and men and high sociodemographic index (SDI) countries, especially in Australasia and North America, bore a disproportionate share of cases and deaths.
METHODOLOGY:
Researchers analyzed data from the Global Burden of Disease Study 2021 database covering 204 countries from 1990 to 2021.
The analysis included age-standardized rates (ASRs) of prevalence, incidence, deaths, and disability-adjusted life years (DALYs) per 100,000 population associated with skin cancer among adults aged 65 years or older.
Disease burden was stratified by sex, age, year, and SDI.
TAKEAWAY:
In 2021, there were an estimated 153,993 new cases of melanoma, 1,463,424 of SCC, and 2,802,354 of BCC.
BCC had the highest incidence rate (ASRs, 371.97), whereas SCC exhibited the highest prevalence (ASR, 236.91) and DALYs (ASR, 95.50). Men had a higher incidence than women, and population growth was the major driver of the increasing disease burden.
The highest ASRs of melanoma incidence (158.10), prevalence (1165.26), deaths (27.83), and DALYs (502.22) were reported in Australasia. North America had the highest incidence and prevalence rates for keratinocyte carcinoma (KC). Australasia also recorded the highest SCC-related deaths (ASR, 15.37) and DALYs (ASR, 226.92). The highest BCC-related DALY rate (ASR, 1.21) was observed in North America.
Melanoma-related death rates were more than five times higher in high SDI countries (ASR, 9.49) than in low-middle to middle SDI countries. Despite high SDI levels, the United States, Greenland, Sweden, and Switzerland had disproportionately high BCC-related DALY rates, while New Zealand, Australia, Norway, North Macedonia, and Slovenia had higher-than-expected melanoma-related DALY rates.
IN PRACTICE:
'The findings of this study suggest that the global disease burden of skin cancer in adults 65 years or older is on the rise, particularly among male individuals and in countries with a high SDI level,' the study authors wrote. 'Our results underscore the urgency to enact prevention and treatment strategies tailored to high-risk older populations.'
SOURCE:
This study was led by Ruiyao Wang, MD, Department of Dermatology, The First Affiliated Hospital of Chongqing Medical University in Chongqing, China, and was published online on May 21 in JAMA Dermatology .
LIMITATIONS:
Limitations included underreporting of KC in major cancer registries, reliance on modeled estimates for countries with limited data, and the absence of race and ethnicity data.
DISCLOSURES:
This study received support from the National Natural Science Foundation of China and Chongqing Science and Technology Commission. The authors did not report any conflicts of interest.
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