Global trends in urological cancers: an analysis of the global burden of disease study 2023.
Abstract
Objectives
Our objective was to quantify changes in the global burden of prostate, bladder, kidney and testicular cancers from 1990 to 2023 and to assess demographic contributions and characterize geographic, age-specific and modelled risk-attributable patterns.
Materials And Methods
We analysed Global Burden of Disease 2023 estimates for incidence, deaths and disability-adjusted life-years (DALYs). Age-standardised incidence rates and death rates were summarised using estimated annual percentage change. We incorporated 95% uncertainty intervals (UIs), decomposed changes in counts into population growth, population ageing and age-specific rate effects, assessed 2021-2023 changes, and repeated country rankings after excluding locations with an implied population <1 million.
Results
In 2023, the four cancers accounted for approximately 2.47 million incident cases, 0.88 million deaths and 18.1 million DALYs. Prostate cancer contributed 1.41 million incident cases (95% UI 1.19-1.63 million) and 469 000 deaths (95% UI 413 000-526 000). From 1990 to 2023, age-standardised incidence rates increased for testicular cancer (estimated annual percentage change 0.98%, 95% confidence interval [CI] 0.89-1.07) and kidney cancer (0.27%, 95% CI 0.13-0.41), was stable for prostate cancer, and decreased for bladder cancer; age-standardised death rates decreased for all four cancers. Together, population growth and ageing accounted for the most increases in incident cases, whereas declining age-specific rates offset deaths from prostate, bladder, kidney and testicular cancers. Small-jurisdiction leaders changed materially in the population-threshold sensitivity analysis. In 2023, all modelled risks accounted for 34.6% (95% UI 29.7-39.8) of bladder cancer DALYs and 27.1% (95% UI 17.0-36.7) of kidney cancer DALYs but only 1.6% (95% UI -5.6 to 6.8) of prostate cancer DALYs.
Conclusion
The growing absolute burden of these cancers was predominantly demographic, but cancer-specific and geographic trajectories differed. Testicular cancer added a young-adult, rising-incidence component to the conventional older-age urological cancer profile. Rankings for small populations require cautious interpretation, and prevention priorities should reflect cancer-specific risk patterns.