Contribution of smoking to the global burden of bladder cancer from 1990 to 2021 and projections to 2046.

Abstract

Introduction: Based on the results extracted from the Global Burden of Disease (GBD) 2021, the objective of this research is to examine the spatiotemporal trends of bladder cancer attributable to smoking from 1990 to 2021, and to make projections up to the year 2046.

Methods: This study conducted a secondary dataset analysis of smoking-attributable bladder cancer data extracted from GBD 2021. Bladder cancer was classified using the International Classification of Diseases 10th Revision (ICD-10) in GBD, and smoking exposure was defined as both current and past use of smoked tobacco products. By employing a Bayesian age-period-cohort (BAPC) model, the average annual percentage change (AAPC) was determined to examine trends over time.

Results: From 1990 to 2021, the number of deaths and disability-adjusted life years (DALYs) due to smoking-attributable bladder cancer increased significantly. The age-standardized death rate (ASDR) decreased, with an AAPC of -1.54 (95% CI: -1.62 - -1.46). The age-standardized DALY rate (ASDLR) also showed a decline, with an AAPC of -1.68 (95% CI: -1.81 - -1.56). The regions that experienced the most significant age-standardized rate (ASR) burden were Central Europe and Western Europe. Regions with high-medium sociodemographic index (SDI) values had the highest number of deaths and DALYs, as well as the highest ASR for both indicators. The heaviest global disease burden is concentrated among males and individuals aged ≥70 years. Smoking-attributable bladder cancer deaths are projected to rise over the next 25 years, reaching 90021.45 by 2046.

Conclusions: Despite a decrease in the ASRs of smoking-attributable bladder cancer, the absolute burden has increased and is expected to continue growing. Therefore, continuous and targeted tobacco control measures and medical strategies are needed, especially for developed regions, the elderly, and male populations. And due to the unique mechanisms by which tobacco causes disease, the youth and female populations should not be neglected.