Incidence and mortality of nonmelanoma skin cancer in Europe: current trends and challenges.

PURPOSE

Nonmelanoma skin cancer (NMSC), predominantly basal cell carcinoma (BCC) and squamous cell carcinoma (SCC), represents the most common malignancy among fair-skinned populations. While BCC is rarely fatal, SCC contributes significantly to NMSC-related mortality. This study aimed to investigate long-term trends in NMSC incidence and SCC mortality across 28 European countries from 1992 to 2021, focusing on regional, sex-specific, and age-related variations.

METHODS/PATIENTS: A longitudinal ecological analysis was conducted using the Global Burden of Disease (GBD) database. Age-standardized incidence rates (ASIRs) for NMSC and age-standardized mortality rates (ASMRs) for SCC were calculated based on the 2013 European Standard Population. Temporal trends were evaluated using joinpoint regression, and age-period-cohort (APC) models were employed to disentangle independent effects on SCC mortality.

RESULTS

Europe registered over 27 million NMSC cases between 1992 and 2021. Overall ASIRs slightly declined, although increasing incidence was observed in individuals under 45 in Central and Northern Europe. SCC accounted for more than 570,000 deaths, with overall ASMRs decreasing-particularly among women and younger men. However, mortality rose in men aged over 75, notably in Northern and Western Europe. APC analysis indicated elevated SCC mortality in cohorts born before 1940, with a notable reversal in Northern European males born after 1960, who exhibited increasing mortality. Period effects further confirmed a recent rise in SCC mortality among these populations.

CONCLUSIONS

Although NMSC incidence appears to be stabilizing or declining in much of Europe, increasing trends in younger individuals and rising SCC mortality in older men-especially in Northern Europe-highlight the need for age- and region-specific prevention and screening strategies. Improved cancer registry harmonization remains essential for guiding effective public health interventions.