Global and Regional Incidence, Mortality Trends and Predictions of Urologic Cancer, 1990-2026: A Systematic Analysis of the Global Burden of Disease Study 2016

Abstract

Background: Urologic cancer, including prostate cancer, kidney cancer, bladder cancer, and testicular cancer, are substantially increasing with the growing and ageing population. This study analyzed trends in the incidence and mortality of these urologic cancers to provide evidence for policy makers to inform national policies for disease prevention and treatment and allocate resources appropriately. Methods: This study used the Global Burden of Disease Study data and methodologies to describe the incidence and mortality trends of urologic cancer from 1990 to 2016. Based on the data, we predicted the 10-year trends in urologic cancer incidence and death. Trends were analyzed over time, as well as by age, sex, and sociodemographic index (SDI). Findings: In 2016, 2282117 new urologic cancer cases occurred worldwide (95% uncertainty interval [UI], 2115350-2486237), nearly 2.2-fold the number in 1990 (1024819; 95% UI, 956085-1072322). Cumulative deaths increased by 1.9-fold from 380801 (95% UI, 353032-404060) in 1990 to 707566 (95% UI, 636888-749766) in 2016. UC incident cases are increased by 55%, while deaths increased by 86% between 1990 and 2016. From 1990 to 2026, kidney cancers in both sexes are projected to increase substantially in high SDI, middle SDI, low-middle SDI, and low SDI countries, while the trends in incidence rates will remain stable globally and in high-middle SDI countries. Globally, the trends in deaths due to kidney cancer will remain stable. Bladder cancer will have the greatest occurrence in high SDI countries, followed by high-middle SDI countries. Moreover, bladder cancer incidence rates may increase substantially in middle SDI countries, while the incidence rates will remain relatively stable in other SDI countries for both sexes. From 1990 to 2026, bladder cancer deaths will continue to increase in low SDI countries, while deaths in other SDI countries will continue to decrease 2026. Of note, from 1990 to 2016, the most common incident urologic cancer globally for men was prostate cancer. Globally, from 1990 to 2026, the trends in prostate cancer incident cases are increasing substantially. By SDI subtypes, prostate cancer will most frequently occur in high SDI countries over the next 10 years, followed by high-middle SDI countries, low SDI countries, middle SDI countries, and low-middle SDI countries. Simultaneously, the trends in prostate cancer deaths are expected to increase worldwide. The highest mortality rates will present in low SDI countries, followed by high SDI countries, high-middle SDI countries, and low-middle SDI countries. However, trends in prostate cancer deaths are expected to slightly decrease in middle SDI countries from 2016 to 2026.Testicular cancer will most frequently occur in high SDI countries and at a highly increased rate. From 1990 to 2026, testicular cancer incident cases are projected to rise in all SDI countries except for the low SDI and low-middle SDI countries, where they will remain stable. However, the trends in testicular cancer deaths decreased in the high-middle SDI countries in 2016, and are projected to increase from 2016 to 2026. Testicular cancer death rates in other SDI countries will decline from 1990 to 2026. Interpretations: The incidence of urologic cancer is highly variable among countries but has increased uniformly since 1990. The findings of increases in total deaths and accelerated population ageing call for specific focus from health policy makers to ensure that health care systems are equipped to meet peoples' needs. However, the incidence and mortality of urologic cancer are steadily increasing globally, resulting in further challenges in the allocation of limited health care resources. The current study provides comprehensive knowledge of the local burden of disease and assists with the appropriate allocation of resources for urologic cancer prevention, screening, and treatment. Funding Statement: The research was funded by the National Natural Science Foundation of China (NSFC, Grant No. 91746205, 71673199, and 71473175). Declaration of Interests: All authors declare no competing interests. Ethics Approval Statement: The present study complies with the Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER).