Non-Melanoma Skin Cancer Mortality in the United States: An Analysis from Centres for Disease Control (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER) 1999–2023

Abstract Background: Nonmelanoma skin cancer (NMSC) is the most common malignancy worldwide, yet comprehensive national mortality surveillance remains limited in the United States (U.S.). Objective: This study aimed to analyse temporal trends and demographic disparities in NMSC mortality in the U.S. from 1999 to 2023. Materials and Methods: Age-adjusted mortality rates (AAMR) for NMSC deaths were obtained from the Centres for Disease Control (CDC) Wide-ranging ONline Data for Epidemiologic Research (WONDER) database. Data were stratified by age, sex, race/ethnicity, urban-rural status, and census region. Joinpoint regression was used to quantify temporal trends, reported as the average annual percent change (AAPC) with 95% confidence intervals (CI). Results: From 1999 to 2023, NMSC caused 82,612 deaths in the U.S. The overall AAMR significantly increased from 1.31 to 1.82 per 100,000 (AAPC: 1.41%; 95% CI: 0.28–2.56). Mortality was higher in males, non-Hispanic White individuals, and older adults. Rural areas had significantly higher mortality than urban areas (AAMR ratio: 1.46). Inland states demonstrated both higher baseline mortality (+38%) and faster growth in mortality rates (AAPC difference: +0.92%) compared to coastal states. Conclusion: NMSC mortality increased substantially in the U.S. between 1999–2023. Significant mortality disparities exist across demographic (sex, race/ethnicity, age) and geographic (urban-rural status, coastal/inland region) subgroups.