Global Burden of Non-Melanoma Skin Cancer Among Elder Adults and Projections to 2071: A Systematic and Comprehensive Analysis of the Global Burden of Disease Study 2021.

Background: Non-melanoma skin cancer (NMSC) poses a significant health burden to the elderly globally. This study seeks to comprehensively assess the burden of NMSC among elderly adults in various regions and countries worldwide, covering the time frame from 1990 to 2021. Methods: Using data from the Global Burden of Disease (GBD) 2021 study, we analyzed global trends in NMSC incidence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021. Joinpoint regression was used to evaluate temporal trends, and an Age-Period-Cohort (APC) model was applied to assess underlying influences. Future projections were made using the Bayesian Age-Period-Cohort (BAPC) model. Results: Data indicates that among all assessment metrics, both the number of cases and age-standardized rates are higher in males than in females, suggesting a more pronounced increase in the disease burden of NMSC among men. Concurrently, the disease burden is significantly higher in the elderly population compared to younger age groups. Across the 21 GBD regions worldwide, the disease burden is heaviest in high-income North America, particularly evident in age-standardized incidence rates (ASIR): from 395.30 (336.70-456.10)/100,000 (95% UI) in 1990, it rose to 1251.80 (1158.40-1341.20)/100,000 (95% UI) in 2015. Additionally, the disease burden and mortality rates in Australasia and Western Europe were generally higher than in other regions. East Asia exhibited a high annual estimated percentage change (EAPC) in age-standardized incidence of 7.1 (6.2-7.9) (95% CI), indicating that NMSC in this region is undergoing a rapid rise, thereby increasing the urgency for prevention and control. Conclusion: From 1990 to 2021, the global burden of NMSC has increased significantly. Elderly populations in various countries with high Standardized Disease Index values are facing a substantial disease burden.