From beach culture to burden: Analysis of skin cancer trends in Australasia using the GBD database (1980–2023).

Abstract

e22607 Background: Australasia (Australia and New Zealand) bears a disproportionate burden of skin cancer, driven by high levels of ultraviolet radiation, outdoor lifestyles, and a largely fair-skinned population. Despite extensive public health campaigns promoting sun protection and early screening, the incidence of skin cancer remains high, and mortality has not declined at the same pace in all demographic groups. Using Global Burden of Disease estimates, this study aims to quantify the trends for skin cancer in Australasia from 1990 to 2023. Methods: Using data from the Global Burden of Disease (GBD) 2023 study, temporal trends in Skin Cancers across Australasia incidence, mortality, and Disability-Adjusted Life Years (DALYs) were analyzed. Join point regression analysis was employed to assess Average Annual Percentage Change (AAPC) and Annual Percentage Change (APC). Results: Skin cancers in Australasia has affected both sub-regions differently, with Australia showing decreasing overall trend with AAPC of -0.25% (95% CI -0.46 to -0.04, p value = 0.018785), however the Age-standardized Death Rate (ASDR) was 3.80 in 1980, which rose minimally to 3.99 in 2023. Whereas, for New Zealand, ASDR spiked from 3.58 to 4.67 from 1980 to 2023. The overall trend was also a stark contrast from Australia with an upward trend [AAPC = 0.58% (95% CI 0.60 to 1.11, p value = 0.028733)]. During 1990-2023, Disability-adjusted life years (DALYs) attributed to skin cancers in Australasia declined and were similar across both Australia [146.50 (1990) to 93.41(2023)] and New Zealand [142.25 (1990) to 134.49(2023)]. The trend however was downward with statistically significant AAPC of -1.33% (95% CI -1.75 to -0.91, p value < 0.000001) for Australia, and non-significant -0.20% (95% CI -0.63 to 0.22, p value = 0.345527). In contrast to DALYs, the incidence of Skin cancers in both sub-regions is on the rise with inclining trend, as reflected by statistically significant Age-standardized Incidence Rate (ASIR) -AAPC of 0.25% (95% CI 0.67 to 0.45, p value = 0.007894) for Australia and 1.44% (95% CI 1.06 to 1.82, p value < 0.00001). Similarly, the prevalence has also increased with a statistically significant trend seen in New Zealand with AAPC of 1.57% (95% CI 1.18 to 1.95, p value < 0.000001), while Australia showed a linear trend with AAPC of 0.48%. Conclusions: Skin cancer trends in Australasia differ by sub-region, with Australia showing declining mortality while New Zealand’s mortality continues to rise. Efforts to raise public awareness appear to have been fruitful, contributing to improved outcomes in Australia, particularly. Despite reductions in DALYs, both countries experienced increasing incidence and prevalence, highlighting the need for better health policies.