# Analysis and comparison of the trends in burden of malignant cutaneous melanoma in East Asian countries and regions and worldwide from 1991 to 2021

## TL;DR

This study examines how the burden of malignant melanoma has changed over 30 years in East Asia and globally, highlighting rising rates and the need for targeted prevention.

## Contribution

The study provides a detailed comparative analysis of malignant melanoma trends in East Asia using global disease burden data and identifies region-specific patterns.

## Key findings

- Malignant melanoma incidence increased most in Korea, with a rise in age-standardized incidence rate from 0.603 to 1.896 per 100,000.
- China saw the largest increase in prevalence, with age-standardized prevalence rate rising from 0.699 to 4.157 per 100,000.
- Mortality and DALY rates increased in Taiwan, with higher rates observed among males and with advancing age.

## Abstract

This study aims to comprehensively analyze temporal trends in the burden of malignant melanoma (MM) in East Asia, focusing on incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1991 to 2021. It further seeks to compare these trends with the global burden of disease.

The study utilized data from the Global Burden of Disease (GBD) database to examine the disease burden of MM across East Asian countries and regions, as well as globally, over a 30-year period (1991–2021).

We assessed changes in the incidence, prevalence, mortality, and DALYs associated with MM in East Asia and globally using GBD database open-source data. To capture the underlying trends in the disease burden, we applied the Joinpoint regression model to calculate the average annual percentage change (AAPC) and corresponding 95% confidence intervals (95% CI). A detailed comparative analysis was conducted to explore differences in the burden of MM across East Asian regions and compared with global trends, with particular emphasis on age, sex, and temporal changes.

The greatest increase in MM incidence in East Asia was observed in Korea, where the age-standardized incidence rate (ASIR) rose from 0.603 cases per 100,000 population (95% CI: 0.389–0.789) in 1991 to 1.896 cases per 100,000 (95% CI: 0.78–2.499) in 2021. Regarding prevalence, China exhibited the most significant increase in East Asia, with the age-standardized prevalence rate (ASPR) increasing from 0.699 (95% CI: 0.451–0.864) per 100,000 in 1991 to 4.157 (95% CI: 2.195–5.633) per 100,000 in 2021. The highest increases in MM mortality and DALYs were noted in Taiwan Province of China, where the age-standardized mortality rate (ASMR) increased from 0.36 (95% CI: 0.339–0.382) per 100,000 in 1991 to 0.414 (95% CI: 0.414) per 100,000 in 2021. Similarly, the age-standardized DALY rate (ASDR) in Taiwan rose from 10.375 (95% CI: 9.781–11.049) per 100,000 in 1991 to 11.647 (95% CI: 10.558–12.478) per 100,000 in 2021. Age and gender exhibited distinct patterns of influence on the MM burden: while ASIR generally increased with age, ASPR initially increased and later plateaued. Both ASMR and ASDR demonstrated a positive correlation with age. Additionally, male populations consistently exhibited higher morbidity and mortality rates than females.

Over the period from 1991 to 2021, there were significant variations in the incidence, prevalence, mortality, and DALY rates of MM across East Asian countries and regions, including China, Japan, South Korea, North Korea, and Taiwan. These disparities underscore the need for region-specific, proactive prevention strategies and targeted public health interventions to mitigate the growing burden of malignant melanoma in the region.