Increasing incidence rates (IRs) of nonmelanoma skin cancer (NMSC) in white populations have been described worldwide. Cancer registry data from the Saarland and Schleswig-Holstein federal states were used to analyze incidence and mortality trends in Germany. Age-standardized rates were compared with crude rates to assess disease burden. Joinpoint regression models were used to estimate annual percentage changes and 95% confidence intervals, allowing us to assess temporal trends between 1970 and 2012. Incidence predictions until 2030 were based on age-period-cohort models and linear extrapolation techniques. In the Saarland federal state, between 1970 and 2012, NMSC age-standardized and crude IRs increased 10- to 22-fold, respectively. In Schleswig-Holstein, between 1999 and 2012 crude IRs doubled, reaching 250 cases/100,000 persons per year in 2012, with age-standardized IRs increasing 1.5-fold. During this period, NMSC mortality remained stable or decreased. For 2030, the predicted age-standardized IRs are as follows: males, 230 cases; females, 180-200 cases. The predicted crude IRs for the same year are males, 450-500 cases; females, 380-430 cases. There is a continuous long-term increase of NMSC incidence with no tendency for leveling off. By 2030, the current NMSC IR in Germany is expected to double.
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