Skin cancer rates growing among older males

Global maps of age-standardized incidence rate attributable to (A) cutaneous melanoma, (B) squamous cell carcinoma, and (C) basal cell carcinoma in 2021. Image by Wang R et al. CC-BY

New findings show the global burden of skin cancer in the older population is growing, particularly in males and those living in high sociodemographic index (SDI) countries. However, much of this growth is driven by an increase in the overall population.

The study, published in JAMA Dermatology (May 21, 2025, online ahead of print), evaluated the global burden of skin cancer among adults 65 years or older from 1990 to 2021 and projected the change in this burden by 2050.

Researchers extracted population-based registry data from the Global Burden of Diseases (GBD) Study 2021. The database covers 204 countries and territories, ensuring the global applicability of the results. They then calculated age-standardized rates of prevalence, incidence, deaths, and disability-adjusted life-years (DALYs) per 100,000 population and estimated rates of disease burden for 2050.

The investigators estimated a worldwide total of 153,993 melanoma, 1,463,424 squamous cell carcinoma (SCC), and 2,802,354 basal cell carcinoma (BCC) instances for 2021. SCC exhibited the highest age-standardized rate of prevalence (236.91 per 100,000 population; 95% uncertainty interval [UI], 188.23-303.82), deaths (6.16 per 100,000 population; 95% UI, 5.13-6.87), and DALYs (95.50 per 100,000 population; 95% UI, 81.65-106.39), whereas BCC displayed the highest incidence rate (371.97 per 100,000 population; 95% UI, 310.75-439.58).

The authors found the disease burden was notably greater in males than in females—roughly double. During the observation period, the global burden of skin cancer among older people demonstrated a general upward trend. Decomposition analysis indicated that population growth was the primary contributor to this increase.

Health inequality analysis revealed a disproportionately higher burden shouldered by countries with higher SDI levels. Specifically, New Zealand and Australia recorded the highest 65 and older melanoma rates in 2021, with an incidence of 158 cases per 100,000 population, a prevalence of 1,165 per 100,000, a mortality rate of 27.8 per 100,000, and 502.2 DALYs per 100,000. High-income North America, alongside Western, Central, and Eastern Europe, had comparable burdens.

The most rapid rise in BCC burden from 1990 to 2021 occurred in East Asia, with average annual percentage increases exceeding 6% for incidence, prevalence, and DALYs.

Frontier analysis identified the countries with considerable potential to mitigate skin cancer. The researchers anticipated that only the incidence and prevalence rates attributable to keratinocyte cancer and the DALY rate related to BCC would increase by 2050.

“Despite the relative incompleteness of [keratinocyte carcinoma] data and lack of race and ethnicity data, these results highlight the urgency for more effective prevention and management strategies targeting high-risk groups,” the authors conclude.