Global, regional and national burden of skin cancer from 1990 to 2021: Analysis of risk factors and prediction of trends in 2035

Skin cancer is among the most common malignancies worldwide, mainly classified into malignant skin melanoma (MSM) and nonmelanoma skin cancer (NMSC). This study aimed to comprehensively analyze the global burden and temporal trends of skin cancer, focusing on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. Data on incidence, mortality, and disability-adjusted life years (DALYs) for skin cancer were obtained from the Global Burden of Disease 2021 database across 204 countries and territories. Both crude numbers and age-standardized rates (ASIR, ASMR, and ASDR) were analyzed. Temporal trends were evaluated using estimated annual percentage change, and autoregressive integrated moving average (ARIMA) models were applied to project age-standardized rates, rather than crude counts, through 2035. In 2021, there were 3,03,105 MSM cases, 18,99,907 squamous cell carcinoma cases, and 44,36,939 basal cell carcinoma cases globally. From 1990 to 2021, the global ASIR of MSM increased by 19.32% (95% UI: 13.60-23.62%), squamous cell carcinoma by 67.34% (95% UI: 42.13-95.42%), and basal cell carcinoma by 63.30% (95% UI: 52.54-77.53%). High-SDI regions showed the highest incidence levels, whereas middle-SDI regions bore relatively higher mortality and DALY burdens. Males consistently exhibited higher incidence, mortality, and DALYs than females, and the disease burden increased markedly with age, particularly among individuals aged ≥ 70 years. ARIMA projections suggest subtype-specific trends, with age-standardized incidence and DALY rates remaining stable or declining for most skin cancer subtypes through 2035. Significant regional disparities persist in the burden of skin cancer. While high-income regions report higher incidence, low-income regions face greater challenges in early detection and treatment. Strengthening UV protection awareness, promoting early screening, and improving healthcare access are essential to reduce the future global burden of skin cancer.