Epidemiology and socioeconomic factors of nonmelanoma skin cancer in the Middle East and North Africa 1990 to 2021

Nonmelanoma skin cancer (NMSC), accounts for approximately 90% of skin cancers. Global incidence is rising, with projections showing a significant increase in cases and disability-adjusted life years (DALYs). However, research on NMSC in the Middle East and North Africa (MENA) region is limited. This study aims to assess the epidemiology and burden of NMSC in the MENA region from 1990 to 2021, by sex, age, and socio-demographic index (SDI). The analysis used data from the Global Burden of Disease 2021 on age-standardized rates and cases of incidence, prevalence, deaths, and DALYs. Estimation of NMSCs death was performed by the Cause of Death Ensemble model, while DisMod-MR 2.1 was used for non-fatal outcomes. Counts and rates were presented with 95% uncertainty intervals. In 2021, the MENA region reported an age-standardized incidence rate of 6.7 per 100,000 population for NMSC, a 14% decrease from 1990. However, the age-standardized death rate increased by 10.5% to 0.3, and the DALY rate increased by 8.2% to 4.9 per 100,000. Among the countries, Turkey had the highest age-standardized DALY rate of 13.5 and the Syrian Arab Republic had the lowest with 0.1 per 100,000. Most cases of the disease were observed in older age groups, especially men aged 65-69 and women aged 60-64. Men had higher incidence, mortality, and DALYs than women in all age groups. From 1990 to 2021, the burden of NMSC increased with increasing SDI. There is variations in the NMSC burden in the MENA region. Interdisciplinary education, policy changes, and healthcare improvements are essential to reduce the burden and incidence of NMSCs in the coming years, particularly in the elderly and high SDI countries.