# Epidemiological trends and future burden of skin and subcutaneous diseases in China: insights from the global burden of disease study 2021

## TL;DR

This study analyzes trends in skin and subcutaneous diseases in China from 1990 to 2021 and projects their future burden through 2050 to guide public health strategies.

## Contribution

The study provides the first age- and sex-stratified projections of SSD burden in China through 2050 using GBD 2021 data and APC modeling.

## Key findings

- Age-standardized incidence and prevalence rates of SSDs increased from 1990 to 2021, while mortality rates declined significantly.
- Males had higher years of life lost (YLL) than females, indicating a greater disease burden among men.
- Projections suggest age-standardized mortality rates will remain low and stable through 2050.

## Abstract

Skin and subcutaneous diseases (SSDs) constitute a major component of the non-fatal disease burden in China, with patterns that have evolved significantly over recent decades. Understanding long-term trends in incidence, prevalence, and mortality, as well as projecting future dynamics, is essential to inform public health strategies and support effective allocation of healthcare resources.

We used data from the Global Burden of Disease Study 2021 (GBD 2021) to analyze the burden of SSDs in China from 1990 to 2021. We estimated incidence, prevalence, and mortality numbers alongside age-standardized rates, employing the Joinpoint model to calculate the annual average percentage change (AAPC) and age-period-cohort (APC) analyses for assessing trends in the burden of skin and subcutaneous diseases. Finally, ARIMA models were used to forecast age-standardized mortality rates through 2050.

From 1990 to 2021, the age-standardized incidence rate (ASIR) of SSDs in China exhibited a modest upward trend (AAPC = 0.11%), while the age-standardized prevalence rate (ASPR) increased more rapidly (AAPC = 0.29%). In contrast, the age-standardized mortality rate (ASMR) declined markedly over the same period (AAPC = −3.60%). In 2021, the ASIR reached 50,120 per 100,000 population (95% UI: 47,601–52,796), while the ASPR was 24,852 per 100,000 (95% UI: 24,126–25,562). Mortality remained low at 0.40 per 100,000 (95% UI: 0.33–0.48); however, YLL and YLD rates indicated a persistent disease burden, particularly among males, who exhibited higher YLLs than females. Joinpoint regression identified consistent period-related increases in incidence and prevalence alongside sustained declines in mortality risk. Age–period–cohort analysis further showed that mortality risk increased with age, whereas incidence and prevalence rose steadily across successive birth cohorts. Projections indicate that age-standardized mortality is likely to remain low and stable over the next decade.

This study provides the first age- and sex-stratified projections of skin and subcutaneous disease burden in China through 2050, based on GBD 2021 data and age–period–cohort modeling. By identifying birth cohorts with the most rapidly increasing disability-adjusted life year (DALY) burden, these findings help identify priority populations and regions for targeted screening, guideline refinement, and pollution control interventions.