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This study evaluates NMSC epidemiology and burden from 1990–2021 by sex, age, and socio-demographic index (SDI) using Global Burden of Disease 2021 data. Results report an incidence decrease in 2021 with rising death and DALYs, with substantial cross-country and age/sex differences. Findings highlight the need for interdisciplinary education, policy changes, and healthcare improvements to reduce future burden, especially in elderly and high-SDI settings.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/epidemiology-and-socioeconomic-factors-of-nonmelanoma-skin-cancer-in-the-middle-east-and-north-africa-1990-to-2021/373376/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/epidemiology-and-socioeconomic-factors-of-nonmelanoma-skin-cancer-in-the-middle-east-and-north-africa-1990-to-2021/373376.png","ImageObject",300,407,{"name":92,"@type":93},"Riley West","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-24","2026-09-23",true,{"@type":102,"interactionType":103,"userInteractionCount":44},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the main objective of this study on nonmelanoma skin cancer in MENA?","Question",{"text":112,"@type":113},"To assess NMSC epidemiology and burden in the Middle East and North Africa from 1990 to 2021 by sex, age, and socio-demographic index (SDI).","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"Which data sources and methods were used to estimate incidence, prevalence, deaths, and DALYs?",{"text":117,"@type":113},"The study used Global Burden of Disease 2021 data on age-standardized rates and counts. Deaths were estimated using the Cause of Death Ensemble model, and non-fatal outcomes were modeled with DisMod-MR 2.1, with 95% uncertainty intervals reported.",{"name":119,"@type":110,"acceptedAnswer":120},"What were the key findings about incidence, death rate, and DALYs in 2021 compared with 1990?",{"text":121,"@type":113},"In 2021, the MENA region showed a lower age-standardized incidence rate (6.7 per 100,000, 14% decrease from 1990), while the age-standardized death rate increased by 10.5% to 0.3 and the DALY rate increased by 8.2% to 4.9 per 100,000.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},373376,1790516936,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":44,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":52,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":143,"read_time":144},1099523885074,"https://ap-avatar.wpscdn.com/davatar_9964176cb1d06d4a9deccf72a44ae3dc","[www. nature.com/scientificreports](www. nature.com/scientificreports)  \nOPEN  \nEpidemiology and socioeconomic factors of nonmelanoma skin cancer in the Middle East and North Africa 1990 to 2021  \nMehra Fekri1, Paria Dehesh2,3, Farzin TahmasbiArashlow4, Hojjat Layegh5, Shirin Zaresharifi6􀀍 & Seyed Aria Nejadghaderi7􀀍  \nNonmelanoma skin cancer (NMSC), accounts for approximately 90% of skin cancers. Global incidence is rising, with projections showing a significant increase in cases and disability-adjusted life years (DALYs) . However, research on NMSC in the Middle East and North Africa (MENA) region is limited. This study aims to assess the epidemiology and burden of NMSC in the MENA region from 1990 to 2021, by sex, age, and socio-demographic index (SDI). The analysis used data from the Global Burden of Disease 2021 on age-standardized rates and cases of incidence, prevalence, deaths, and DALYs. Estimation of NMSCs death was performed by the Cause of Death Ensemble model, while DisMod-MR 2.1 was used for non-fatal outcomes. Counts and rates were presented with 95% uncertainty intervals. In 2021, the MENA region reported an age-standardized incidence rate of 6.7 per 100,000 population for NMSC, a 14% decrease from 1990. However, the age-standardized death rate increased by 10.5% to 0.3, and the DALY rate increased by 8.2% to 4.9 per 100,000. Among the countries, Turkey had the highest agestandardized DALY rate of 13.5 and the Syrian Arab Republic had the lowest with 0.1 per 100,000 . Most cases of the disease were observed in older age groups, especially men aged 65–69 and women aged  \n60–64. Men had higher incidence, mortality, and DALYs than women in all age groups. From 1990 to 2021, the burden of NMSC increased with increasing SDI. There is variations in the NMSC burden in the MENA region. Interdisciplinary education, policy changes, and healthcare improvements are essential to reduce the burden and incidence of NMSCs in the coming years, particularly in the elderly and high SDI countries.  \nKeywords Skin cancer, Disability-adjusted life years, Middle East, Global burden of disease, Epidemiology  \nSkin cancer is among the most diagnosed forms of cancer, classified into melanoma and nonmelanoma skin cancer (NMSC) with NMSC being the most common neoplasm in the white population. About 90% of total skin cancers are NMSCs. The two most frequent forms of NMSC, squamous cell carcinoma (SCC) and basal cell carcinoma (BCC), together account for approximately 99% of all NMSC cases1–3. SCC predominantly originates from actinic keratosis, a precursor lesion characterized by dysplastic epidermal keratinocytes4. In contrast, BCC mainly manifests as slow-growing, dome-shaped papules with raised, telangiectatic borders. More than 80% of NMSCs occur in sun-exposed areas, primarily the head and neck3, with ultraviolet (UV) radiation as the leading risk factor. Other contributing factors include age, sex, skin type, genetics, immunosuppression, certain therapies, and family history5.  \nAlthough the overall mortality rate of NMSC is quite low, SCC-specific deaths are rising, with a tumorspecific mortality rate of 1.1–3.2% . The prognosis worsens with metastasis, tumor thickness, desmoplastic  \n1School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2Social Determinants of Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran.  \n3Department of Biostatistics and Epidemiology, School of Public Health, Kerman University of Medical Sciences, Kerman, Iran. 4Medical Students Research Centre, Iran University of Medical Sciences, Tehran, Iran. 5Department of Plastic Surgery, Shahid Beheshti University of Medical Sciences,Tehran, Iran. 6Skin Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 7HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman Universi","cbCaifEFzYUchlD8","https://ap.wps.com/l/cbCaifEFzYUchlD8","pdf",1974370,"English","# Background\n## NMSC burden and risk factors\n## Need for MENA-specific evidence\n# Study Aim\n# Data and Methods\n## Outcomes and modeling approach\n## Measures and uncertainty intervals\n# Results\n## Incidence, mortality, and DALYs trends (1990–2021)\n## Country differences\n## Sex- and age-specific patterns\n## Relationship with SDI\n# Discussion and Public Health Implications\n## Education, policy, and healthcare improvements","[{\"question\":\"What was the main objective of this study on nonmelanoma skin cancer in MENA?\",\"answer\":\"To assess NMSC epidemiology and burden in the Middle East and North Africa from 1990 to 2021 by sex, age, and socio-demographic index (SDI).\"},{\"question\":\"Which data sources and methods were used to estimate incidence, prevalence, deaths, and DALYs?\",\"answer\":\"The study used Global Burden of Disease 2021 data on age-standardized rates and counts. Deaths were estimated using the Cause of Death Ensemble model, and non-fatal outcomes were modeled with DisMod-MR 2.1, with 95% uncertainty intervals reported.\"},{\"question\":\"What were the key findings about incidence, death rate, and DALYs in 2021 compared with 1990?\",\"answer\":\"In 2021, the MENA region showed a lower age-standardized incidence rate (6.7 per 100,000, 14% decrease from 1990), while the age-standardized death rate increased by 10.5% to 0.3 and the DALY rate increased by 8.2% to 4.9 per 100,000.\"}]","Epidemiology and socioeconomic factors of nonmelanoma skin cancer in the Middle East and North Africa 1990 to 2021 | PDF",1790199426,25]