Quantifying the effects of ultraviolet radiation on cutaneous melanoma, 1990—2021, and projecting to 2032

BACKGROUND: The global burden of cutaneous melanoma (CM) remains substantial, yet its temporal trends and relationships with ultraviolet radiation (UVR) and socioeconomic context remain incompletely understood. METHODS: Global Burden of Disease Study data from 1990 to 2021 were analyzed using Joinpoint regression, mixed-effects models, and time-lagged random forest models to assess CM burden and its associations with MODIS-derived UVR and gross domestic product (GDP). A UVR-enhanced ARIMA-X model projected burden to 2032. RESULTS: CM burden showed marked spatiotemporal heterogeneity. Age-standardized incidence was highest in Australasia (47.71 per 100,000) and lowest in Sub-Saharan Africa. Male mortality exceeded female mortality by 26%, with the largest increases among adults aged ≥70 years. UVR was positively associated with CM incidence (β = 0.001, P = 0.038). Time-lagged analysis showed a biphasic UVR pattern, with predictive contribution peaking at 18.2% at an 11-year lag. GDP per capita showed an inverse association with CM incidence (β = -0.200, P = 0.040), but this finding should be interpreted as a contextual population-level association. By 2032, mortality and incidence are projected to decline by 1.2% and 1.6%, respectively, whereas prevalence and DALYs are projected to rise. CONCLUSIONS: Global CM burden remains heterogeneous and is positively associated with ambient UVR, with the strongest predictive contribution at an 11-year lag. Socioeconomic associations should be interpreted cautiously. UVR-oriented prevention, early detection, and context-specific strategies remain essential.