Global, regional, and national burden of premenopausal and postmenopausal malignant melanoma from 1990 to 2021: a comprehensive cross-sectional analysis

Malignant melanoma is a highly fatal disease closely associated with sex hormones. This study aimed to evaluate the global burden and trends of malignant melanoma based on menopausal status. Data on the prevalence, disability-adjusted life years (DALYs), and mortality of malignant melanoma were obtained from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. Age 55 was used as a threshold for menopausal status to assess global, regional, and national trends in disease burden among women. In 2021, the age-standardized prevalence rate (ASPR) of malignant melanoma was higher in women than men under 55 years but lower in women over 55 years. From 1990 to 2021, the ASPR for premenopausal women increased from 14.23 [95% uncertainty interval (UI) (13.79-14.60)] to 16.53 [95% UI (15.09-17.78)], while the age-standardized DALYs rate (ASDR) decreased from 14.04 [95% UI (12.20-15.61)] to 11.83 [95% UI (9.20-14.35)], and the age-standardized mortality rate (ASMR) decreased from 0.27 [95% UI (0.24-0.30)] to 0.23 [95% UI (0.18-0.28)]. For postmenopausal women, the ASPR increased from 55.01 [95% UI (51.71-57.23)] to 81.43 [95% UI (74.33-87.03)], while the ASDR decreased from 63.88 [95% UI (58.39-69.64)] to 56.11 [95% UI (48.79-63.66)], and the ASMR decreased from 2.96 [95% UI (2.69-3.19)] to 2.73 [95% UI (2.36-3.07)]. The disease burden was highest in high socio-demographic index (SDI) regions but has recently decreased, whereas a gradual increase was observed in high-middle SDI regions. At the national level, New Zealand had the highest ASPR for both premenopausal and postmenopausal women, with values of 245.63 [95% UI (209.56, 279.91)] and 909.37 [95% UI (754.63, 1037.39)], respectively. Regional variations in population-level determinants of disease burden were identified. The risk and prognosis of malignant melanoma in women may differ by menopausal status due to the interplay of sex hormones and the immune system. Further research is needed to develop tailored screening and treatment strategies for women across diverse SDI regions and menopausal statuses.