Global burden of cutaneous melanoma incidence attributable to ultraviolet radiation in 2022

Cutaneous melanoma (CM) accounted for around 331,700 cancer cases globally in 2022. Ultraviolet radiation (UVR) is a major CM risk factor. In this study, we update and improve global estimates of UVR-attributable CM cases. Population attributable fractions (PAFs) were calculated by age, sex, and country using GLOBOCAN 2022 national incidence estimates comparing to a minimally exposed Nordic 1930 birth cohort reference population. Adjustments for acral lentiginous melanoma were made to exclude non-UVR-associated melanomas. In sensitivity analyses, PAFs were recalculated with a theoretical minimally exposed 1903 South Thames, England birth cohort and world region-specific reference populations. An estimated 267,353 (95% uncertainty intervals [UI]: 242,818, 278,638) CM cases were UVR attributable globally in 2022. Males contributed to a larger proportion (57%, 151,921 out of 267,353) of UVR-attributable CMs. We found significant regional variation with the highest PAF observed in Australia/ New Zealand, Northern Europe, and North America, all with more than 95% CM cases UVR-attributable. Attributable age-standardized rates were highest in regions with populations of lighter skin color such as Australia/New Zealand, Northern Europe, and North America, with 75.68 (95%UI: 74.50, 76.86), 36.82 (95%UI: 36.38, 37.26) and 33.69 (95%UI: 33.47, 33.91) attributable cases per 100,000 people. By age group, the burden increased with age, with PAF of 76.39% (95%UI: 66.24, 81.01) among people aged 30-49 versus 86.13% (95%UI: 80.04, 88.99) among 70+ years. Most of the global CM burden in 2022 was UVR-attributable. Primary prevention through increasing sun safety awareness and affordable sun protection provision options is key to reducing CM.