OBJECTIVES : Nonmelanoma skin cancer (NMSC) is one of the most frequent cancers worldwide, with 7.7 million incident cases estimated in 2017 by the Global Burden of Disease Cancer Collaboration. In this study, we have estimated the prevalence and mortality associated with NMSC in mainland Portugal, through the adaptation and validation of an economic decision model integrating the various disease states of NMSC.

METHODS : A population-based multiple cohort model was used to estimate the pathway of the Portuguese adult population as it transitioned between different health states of NMSC between 2010 and 2019. The model considers both basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) and reflects the epidemiology and disease dynamics over time. The Markov model includes the health states free of lesion, non-diagnosed, diagnostic & treatment, follow-up and death.

RESULTS : A total of 308,674 prevalent cases of BCC and 71,423 prevalent cases of SCC were estimated in mainland Portugal in 2019, which corresponds to a ratio of 4.3 cases of BCC for each case of SCC. Women registered a higher prevalence of BCC than men with 57% of cases. Approximately 36% and 73% of the total number of prevalent cases of BCC and SCC, respectively, are in the less severe states of the disease. A total of 1,638 deaths by SCC stage IV were estimated over the modeling period of ten years, which corresponds to one death per 44 cases of SCC.

CONCLUSIONS : This study provides evidence on the burden associated with NMSC in Portugal. NMSC represents a large public health problem and efforts to understand how to mitigate the disease burden are warranted.