Kidney, Prostate, and Bladder Cancer Burden Attributable to Tobacco Smoke Exposure in BRICS Countries from 1990 to 2021: A Systematic Analysis Based on the Global Burden of Disease Study.

Background: While tobacco smoke remains a leading modifiable risk factor for urologic cancers, comprehensive assessments in BRICS countries are scarce. We aimed to quantify the burden of kidney, prostate, and bladder cancers attributable to tobacco exposure from 1990 to 2021 in BRICS countries. Methods: We estimated tobacco-attributable deaths, disability-adjusted life years (DALYs), years of life lost (YLLs), and years lived with disability (YLDs) for kidney, prostate, and bladder cancers in BRICS nations using data from the Global Burden of Disease Study 2021. The data were stratified by sex, age, and sociodemographic index (SDI) and analyzed for temporal trends using the estimated annual percentage change (EAPC). Forecasts until 2050 were produced using autoregressive integrated moving average (ARIMA) modeling. Results: In 2021, tobacco-related genitourinary cancers caused approximately 85,000 deaths and 1.8 million DALYs in BRICS countries. While age-standardized DALY rates declined in most countries, absolute burdens rose due to aging and population growth. Bladder cancer contributed the greatest burden, with notable sex disparities: males experienced significantly higher rates across all three cancers. Russia and South Africa had the highest age-standardized rates, while China and India bore the largest absolute burdens. YLLs dominated the total burden, but YLDs increased faster over time, indicating a growing need for survivorship care. Conclusion: Despite some progress in reducing age-standardized rates, tobacco-attributable urologic cancer burdens continue to rise in BRICS countries. Targeted tobacco control, early detection, and long-term survivorship care are essential to mitigate future impacts.