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Soo Park, MD
Soo Park, MD
Posted: Friday, August 1, 2025
In an observational study published in JAMA Dermatology, Wang et al evaluated the global burden of skin cancer among adults aged 65 years and older from 1990 to 2021. They found that there was a significant increased over the 3 decades, and projected rates of keratinocyte cancers would continue to rise in this age group through 2050. However, they found cases of melanoma are projected to decrease by 2050.
Study Details
To ensure global applicability, population-based registry data were extracted from the Global Burden of Diseases Study 2021, which covers 204 countries and territories. Age-standardized rates of prevalence, incidence, deaths, and disability-adjusted life-years (DALYs) were calculated per 100,000 people, and disease burden rates were estimated for the next 25 years.
Investigators analyzed the incidence, prevalence, mortality, and DALYs for cutaneous melanoma and keratinocyte cancers—including basal cell carcinoma (BCC) and squamous cell carcinoma (SCC). Statistical approaches were employed to assess temporal trends, sociodemographic disparities, and future burden estimates.
Key Results
The authors reported that incidence and DALYs associated with keratinocyte cancers are on the rise—particularly in high-income countries and among men—and this upward trend is projected to continue through 2050.
In 2021, older adults globally accounted for an estimated 153,993 melanoma cases, 1,463,424 cases of SCC, and 2,802,354 cases of BCC. BCC had the highest incidence (371.97 per 100,000 people, 95% uncertainty interval [UI] = 310.75–439.58), while SCC had the highest age-standardized rate of prevalence (236.91 per 100,000; 95% UI = 188.23–303.82), deaths (6.16 per 100,000; 95% UI = 5.13–6.87), and DALYs (95.50 per 100,000; 95% UI = 81.65–106.39). Men exhibited substantially higher rates than women across all metrics; for example, the incidence rate of SCC was nearly 230% higher in men (286.89 per 100,000) vs women (128.29 per 100,000).
During the observation period, the global burden of skin cancer among older people demonstrated a general upward trend, with incidence rates increasing with age. Individuals aged ≥ 95 years faced the highest DALYs: 485.05 per 100,000 for SCC and 180.51 for melanoma.
Residents of high-income regions bore the greatest burden, likely due to better detection, but also because of higher rates of ultraviolet exposure and aging populations. Decomposition analysis revealed that population growth was the dominant factor driving the increase—especially in countries with a higher sociodemographic index, where it accounted for over 139% of the BCC increase.
The Bayesian age–period–cohort model projected that by 2050, melanoma prevalence may decrease by up to 45.9%, potentially due to therapeutic advances. In contrast, incidence and DALYs for keratinocyte cancers are expected to climb substantially, with projections for BCC of > 140% and 43.75%, respectively.
The authors concluded: “The older population (particularly male individuals and those living in high-[sociodemographic index] countries) is facing a substantial growing burden of skin cancer. These findings highlight the urgent need for targeted prevention strategies and resource allocation to address the growing public health challenge of skin cancer among the aging population.”
Disclosure: The authors reported no conflicts of interest. For full disclosures of the study authors, visit jamanetwork.com.
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