Global insight of early-onset genitourinary cancers in adolescents and adults from 1990 to 2021: temporal trends and health inequalities analyses.

Abstract

Background: Prostate, bladder, and kidney cancers represent the three most prevalent genitourinary malignancies, posing substantial global health burdens. Given the limited epidemiological research on early-onset genitourinary cancers (EOGCs), this study aims to investigate the temporal trends and health disparities in EOGCs from 1990 to 2021.

Methods: Based on the Global Burden of Disease Study 2021 (GBD), we extracted data on the incidence, prevalence, mortality, and disability-adjusted life years (DALYs) of the three major genitourinary cancers (prostate, bladder, kidney cancer) among individuals aged 15 to 49. We described the distribution of EOGCs at the global, regional and national levels, and analyzed the overall and local time trends through the estimated annual percentage change (EAPC) and joinpoint regression. Spearman's test and health inequality analysis were used to examine the relationship between the disease burden of EOGCs and the Socio-demographic Index (SDI).

Results: In 2021, the incident cases of early-onset kidney cancer (EOKC), early-onset bladder cancer (EOBC), and early-onset prostate cancer (EOPC) were 52,631, 31,054, and 17,865, respectively, with 10,978, 6,328, and 2,861 death cases. The most significant attributable risk factors for EOGC-related deaths and DALYs were smoking and high body mass index. Of particular note, male EOKC consistently demonstrated the highest age-standardized incidence rate (ASIR) and mortality rate (ASMR), with both metrics exhibiting sustained increases from 1990 to 2021, corresponding to EAPCs of 1.33% and 0.3%, respectively. The disease burdens of EOGCs were distributed differently across various regions and countries, and their local trends also varied during the period from 1990 to 2021 globally. The incidence burden of EOGCs was disproportionately concentrated in high-SDI countries, with the concentration indices of EOPC, EOBC and EOKC in 2021 being 0.26, 0.17 and 0.27 respectively. Notably, in regions or countries with a higher SDI, the incidence risk of EOGCs was relatively high, but the mortality risk decreased significantly.

Conclusions: EOGCs are a major global public health challenge. There is an urgent need for personalized healthcare strategies to alleviate the burden of genitourinary cancers, particularly kidney cancer and prostate cancer, among adolescents and adults.