Diverging Incidence and Mortality of Cutaneous Melanoma in Mainland China, 1990-2023, with Projections to 2030: A Global Burden of Disease 2023 Analysis.

OBJECTIVE: To quantify changes in incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) from cutaneous melanoma in mainland China, assess demographic drivers, and project age-standardized rates to 2030 using Global Burden of Disease (GBD) 2023 estimates. METHODS: We extracted annual estimates for 1990-2023 by sex and 5-year age group. Estimated annual percentage changes summarized age-standardized rate trends. Decomposition separated changes in absolute burden into population growth, population aging, and epidemiological change, defined as residual changes in age-specific rates after demographic effects. Bayesian age-period-cohort models projected age-standardized rates to 2030. RESULTS: From 1990 to 2023, incident cases increased from 4,657 to 16,593, and prevalent cases increased from 15,401 to 102,526. The age-standardized incidence rate increased from 0.49 to 0.79 per 100,000, and the age-standardized prevalence rate increased from 1.39 to 5.03 per 100,000, with estimated annual percentage changes of 1.39% and 4.14%, respectively. In contrast, the age-standardized mortality rate declined from 0.33 to 0.27 per 100,000, and the age-standardized DALY rate declined from 9.74 to 7.54 per 100,000. The burden shifted toward older ages, although the largest absolute numbers of cases and DALYs clustered around ages 55-59 years. Aging contributed most to rising incident cases and DALYs, whereas epidemiological change drove prevalence expansion and partly offset DALY growth. By 2030, the combined-sex age-standardized incidence and prevalence rates were projected to reach 0.88 and 5.84 per 100,000, respectively, while mortality was projected to remain nearly stable and the DALY rate to decline slightly. CONCLUSION: Cutaneous melanoma in mainland China remains uncommon but rising incidence and prevalence, alongside declining age-standardized mortality and DALY rates indicate a changing burden profile. This divergence may increase demand for longitudinal services, but it does not demonstrate improved individual survival or chronicity. Strengthened early detection, age-adapted prevention, standardized diagnosis, and long-term survivorship care are needed.