BJU international · 2026
Global trends in urological cancers: an analysis of the global burden of disease study 2023.
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Lu Hanbo, Zhang Yusa, Zhao Yang, Zhang Yushi
Аннотация
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.
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.