Rising Global Burden and Sex Disparities in Nonmelanoma Skin Cancer: 1990-2021 Trends With Projections to 2036

Nonmelanoma skin cancer (NMSC), mainly comprising basal and squamous cell carcinomas, is among the most common cancers worldwide. Despite its low mortality, the rising incidence imposes substantial health and economic burdens. This study assessed the global NMSC burden (1990-2021), examined sex-specific regional patterns, and projected trends to 2036 to inform equitable public health strategies.

Data on NMSC from 1990 to 2021 were retrieved from the 2021 Global Burden of Disease Study across 204 countries. Key indicators included incidence, mortality, and disability-adjusted life years (DALYs), stratified by sex, age, region, and Sociodemographic Index (SDI). Temporal trends were evaluated using age-standardized rates, and the future burden (2022-2036) was projected using autoregressive integrated moving average (ARIMA) models.

Globally, NMSC cases rose 2.8-fold from 1990 to 2021, reaching 6.3 million in 2021. Men accounted for 58% of cases and 59% of DALYs, with higher incidence, mortality, and DALY rates than women, especially in those 70 years or older, and the sex gap widened over time in high-SDI regions. In adults aged 15 to 49, incidence was occasionally higher in women. Regionally, high-income North America showed the highest incidence, whereas East Asia had the greatest deaths and DALYs. By 2036, global incidence is projected to nearly double, with a steeper increase in men.

The global burden of NMSC is rising, and men consistently experience higher incidence, mortality, and DALY rates than women. The expanding sex gap, especially among older adults and in high-SDI regions, highlights the urgent need for targeted and sex-specific prevention, early detection, and public health interventions.