Report Burden of skin cancer in Colombia Martijn Meijs 1 , MD, Astrid Herrera 2 , MSc, Alvaro Acosta 3 , MD and Esther de Vries 4 , PhD 1 Department of Dermatology, Bovenij Hospital Amsterdam, Amsterdam, the Netherlands, 2 The University of Antioquia, Antioquia, Colombia, 3 Department of Dermatology, Nacional Cancer Institute of Colombia, Bogot a, Colombia, 4 Department of Clinical Epidemiology and Biostatistics, Pontificia Universidad Javeriana, Bogot a, Colombia Correspondence Martijn Meijs, MD Department of Dermatology Bovenij Hospital Amsterdam Amsterdam, the Netherlands E-mail: mmmeijs@live.nl Location research conducted: Pontificia Universidad Javeriana, Bogot a Colombia Conflict of Interest: None. Funding source: None. doi: 10.1111/ijd.16077 Abstract Background Levels of incidence and mortality of skin cancer in Colombia and Latin America are largely unknown. Objectives Present the available information from official and gray literature and governmental databases to grasp the magnitude and characteristics of skin cancer in Colombia (middle-income Latin American country). Methods Narrative review based on a literature search (2005–2020), gray literature and cancer registry and governmental warehouse data, calculation of proportions and age- standardized incidence (ASIR) and mortality rates (ASMR), expressed per 100,000 person- years. Results ASIR of cutaneous melanoma in Colombia is around 3, corresponding ASMR between 0.7 and 0.8. Distinctive features are the high proportion and rates for acral melanomas, and the advanced stage at diagnosis in the general population but not in private clinics. For non-melanoma skin cancer, ASIR is at least around 35–40, ASMR 0.8. Conclusions Among the wealthy Colombians, melanoma features are similar to those of high incidence countries (but of lower magnitude), whereas the majority of the population present distinct features with a much higher proportion of acral melanomas, very late stages at diagnosis, and poor prognosis. More advanced melanomas seem to have a relation with lower socioeconomic status. Non-melanoma skin cancer is common, with very high mortality rates at levels even above those of predominantly fair-skinned populations, implying high fatality rates for non-melanoma skin cancers. This could indicate a late diagnosis or difficulties in access to treatment, illustrating the need for primary and secondary prevention to reduce the burden of disease and improve the prognosis of this common cancer. Introduction Skin cancer is classically seen as a disease of predominantly fair skin types (Fitzpatrick phototypes 1–3) and divided into two broad groups: cutaneous malignant melanoma (CMM) and non- melanoma skin cancer (NMSC consisting of the keratinocyte can- cers: squamous [SCC] and basal cell carcinomas [BCC], some- times also including lymphomas, appendageal, fibromatous, and myomatous carcinomas). 1,2 Very few reports are available on skin cancer burden in predominantly more pigmented populations (Fitzpatrick phototypes 4–6), probably because of their lower risk because of their complexion and lower availability of cancer reg- istries. 1–3 However, more pigmented people also develop skin cancer, particularly if they live in areas with high ambient UV exposure, such as those living close to the equator and/or at high altitudes. 4,5 Additionally, many low-incidence countries have important high-risk subpopulations, with sun-sensitive skin, scars, or use of immunosuppressive medication and living in tropical conditions or at high altitudes. Colombia is a middle-income country in the North-West of South America, located close to the equator, with a tropical cli- mate presenting variation within six natural regions depending on the altitude. The ~49 million inhabitants are relatively young, and 6.5% of the population is aged 65 years or older. Health- care expenses are increasing; in 2014 this was USD 26.7 bil- lion, 24% financed by the private sector. 6 Healthcare insurance is divided into a premium-bound contributive scheme for employees, retirees, and self-employed persons and a subsi- dized scheme for the unemployed or people with very low incomes. Those insured in the subsidized regime are in a small majority compared to the contributory regime (47 and 43% of the population, respectively). This out of a total of 95.4% of the population that was insured in 2015. 6 In addition, some people have private insurance or pay out of pocket for medical atten- tion. The Colombian population consists of 58% mestizos (mix of European and American Indian descent), around 20% white people, 14% mulattos (mix of European and African descent), 4% Afro-colombians, 3% mix of Afro and Indigenous descent, ª 2022 the International Society of Dermatology. International Journal of Dermatology 2022, 61, 1003–1011 1003 13654632, 2022, 8, Downloaded from https://onlinelibrary.wiley.com/doi/10.1111/ijd.16077 by Readcube (Labtiva Inc.), Wiley Online Library on [29/11/2022]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License