Patients Over 60 Face Increasing Melanoma Risk as Global Burden Shifts

Cutaneous malignant melanoma (CMM) remains one of the most lethal forms of skin cancer, accounting for more than 90% of skin cancer-related deaths, with incidence and mortality disproportionately affecting older adults.¹ As global populations age, understanding melanoma burden among elderly individuals has become increasingly important for dermatologists, public health officials, and health systems. A new study provides a comprehensive, population-level assessment of the global burden and temporal trends of CMM in patients aged 60 years and older using data from the Global Burden of Disease Injuries, and Risk Factors Study (GBD) 2021.²

Study Design and Data Sources

The researchers analyzed melanoma incidence, mortality, and disability-adjusted life years (DALYs) attributable to CMM in the elderly population across 204 countries and territories from 1990 to 2021. Data were stratified by age, sex, geographic region, and socio-demographic index. The GBD framework integrates cancer registry data, vital registration systems, and modeled estimates to provide standardized comparisons over time and across regions. Age-standardized rates (ASRs) were used to assess temporal trends, while estimated annual percentage changes (EAPCs) quantified changes in burden over the study period.

Global Burden of Melanoma in Older Adults

In 2021, elderly patients accounted for a substantial proportion of the global melanoma burden. The research found that both melanoma incidence and mortality increased markedly with age, with the highest rates observed in those aged 80 years and older. Globally, elderly men experienced significantly higher incidence and mortality rates than elderly women, highlighting persistent sex-based disparities in melanoma outcomes.

Although the overall age-standardized incidence rate of melanoma increased globally between 1990 and 2021, mortality and DALY rates demonstrated more heterogeneous patterns. These findings suggest that while melanoma diagnoses in older adults are rising, survival outcomes may be improving in some regions, potentially reflecting advances in early detection and systemic therapies.

The authors emphasized that cumulative UV exposure, age-related immune senescence, delayed clinical recognition, and comorbidities contribute to poorer melanoma outcomes in elderly patients. Older adults are more likely to present with thicker tumors and advanced-stage disease, which partially explains higher mortality rates despite lower overall incidence in some regions.

Geographic and Socioeconomic Disparities

Marked geographic variation in melanoma burden was also observed. High-income regions, particularly Australasia, Western Europe, and North America, exhibited the highest age-standardized incidence rates among the elderly. Australasia consistently demonstrated the greatest melanoma burden, reflecting high ultraviolet (UV) exposure, fair-skinned populations, and historically elevated melanoma incidence.

Conversely, low- and middle-income regions showed lower incidence rates but comparatively higher mortality-to-incidence ratios, suggesting delayed diagnosis, limited access to dermatologic care, and disparities in treatment availability. Countries with higher SDI levels generally experienced higher incidence rates but lower mortality and DALY rates.

From 1990 to 2021, the global age-standardized incidence rate of melanoma in the elderly increased steadily, with the most pronounced rises observed in high-SDI regions. In contrast, mortality and DALY rates demonstrated stable or declining trends in several developed regions, including Western Europe and Australasia. These trends likely reflect improvements in public awareness, screening, and the introduction of effective immunotherapies and targeted treatments.

However, in several low- and middle-SDI regions, melanoma mortality rates increased or declined more slowly, highlighting ongoing global inequities. The study also identified faster increases in burden among elderly men compared with women, reinforcing the need for targeted prevention and early detection strategies in this population.

Implications for Practice and Public Health

“The rising burden reflects the challenge of an aging world and our success in early detection, while the falling mortality rates celebrate the triumph of modern oncology... Our study calls for a dynamic and targeted re-evaluation of global CMM control strategies,” the study authors wrote.

For dermatology clinicians, this analysis highlights the growing clinical and public health burden of melanoma in older adults worldwide. The increasing incidence among elderly populations, particularly elderly men, reinforces the need for age-inclusive screening strategies, tailored patient education, and vigilance in evaluating new or changing lesions in older patients.

From a policy perspective, the findings support expanded melanoma prevention efforts targeting older populations, especially in high-UV and high-incidence regions. In lower-SDI countries, improving access to dermatologic care, pathology services, and systemic therapies remains critical to reducing melanoma-related mortality.

References

1. Du Z, Li X, Tan W, et al. Global Burden and Trends of Cutaneous Malignant Melanoma in the Elderly Population: Analysis of Global Burden of Disease Study 2021. Clin Cosmet Investig Dermatol. 2025;18:3429-3442. Published 2025 Dec 15. doi:10.2147/CCID.S555090

2. Sun Y, Shen Y, Liu Q, et al. Global trends in melanoma burden: A comprehensive analysis from the Global Burden of Disease Study, 1990-2021. J Am Acad Dermatol. 2025;92(1):100-107. doi:10.1016/j.jaad.2024.09.035