Global and regional burden of kidney cancer: Analysis and future predictions based on GBD data from 1990 to 2021.

Abstract

521 Background: Kidney cancer, as a common urological malignancy with poor prognosis, shows significant variations in incidence and mortality rates in different countries and regions worldwide. This study aims to investigate the global burden and trends of kidney cancer from 1990 to 2021, and to analyze its associations with various factors. Methods: First, data on the number of kidney cancer cases and age-standardized rates (ASR) of incidence, prevalence, mortality, and disability-adjusted life years (DALYs) from 1990 to 2021 were collected and analyzed globally. Subgroup analyses based on sex, country, region, and sociodemographic index (SDI) were then performed to examine the current status and time trends from 1990 to 2021 of kidney cancer in the total population and various subgroups. In addition, the age-period-cohort (APC) and Bayesian age-period-cohort analysis (BAPC) models were used to track dynamic changes in disease burden and predict future trends of the above indicators. Finally, risk factors and trend changes related to kidney cancer mortality within SDI subgroups were analyzed. Results: Globally, the incidence of kidney cancer increased sharply from 1.6×10 5 in 1990 to 3.9×10 5 in 2021. The ASRs for all measures of kidney cancer burden were higher for men than for women. China has the highest number of cases, deaths and DALYs in 2021, followed by the United States. The country of Cabo Verde and the region of Western Europe have the fastest growing ASRs for both incidence and mortality. 49 countries or regions, mainly in Western Europe and North America, have a decreasing trend in ASR for mortality over the period. Overall, the burden of kidney cancer increased with higher SDIs, with countries with middle and low-middle SDIs having the fastest growing burden of kidney cancer, such as North Africa and the Middle East. The APC and BAPC models predicted a steady decline in the ASRs of incidence, prevalence, mortality and DALYs for kidney cancer over the next 20 years, although the APC model predicted a continued steady increase in the absolute numbers of these indicators. In addition, high BMI and smoking were identified as the major risk factors contributing to kidney cancer deaths. High body mass index was particularly pronounced in countries with low SDIs. Conclusions: From 1990 to 2021, the incidence of kidney cancer has declined from historical peaks in developed countries, but remains on an upward trend in developing countries and represents a significant health threat. Revealing some previously unreported findings, the formulation of appropriate policies to reduce population exposure to risk factors associated with kidney cancer could be beneficial in the context of global aging trends.