Incidence, mortality, and risk factors of bladder, kidney, prostate and testicular cancers in China and comparisons with the United States, the United Kingdom, Japan, and the Republic of Korea: an up-to-date overview based on the Global Burden of Disease 2021.

Abstract

Background: The burden of genitourinary cancers has significantly changed in China over the recent decades. This study aims to identify the epidemiological trends and disparities in four common genitourinary cancers, including bladder, kidney, prostate, and testicular cancers, to inform public health strategies and interventions.

Methods: Based on the Global Burden of Disease Study 2021, we examined incident cases, mortality, age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), mortality-to-incidence ratios (MIRs), and risk factors for four genitourinary cancers globally and in the East Asia and Pacific, China, Japan, the Republic of Korea, the United States, and the United Kingdom from 1990 to 2021 across four specified age groups: 0-14, 15-49, 50-74, and ≥ 75 years. Trend analysis was conducted using Joinpoint analysis to calculate the average annual percentage changes (AAPCs). Decomposition analysis was performed to identify the population-level factors contributing to these trends.

Results: In 2021, China reported approximately 266,887 incident cases and 108,589 deaths from genitourinary cancers, exhibiting distinct age-related patterns. ASIRs for male kidney cancer among those aged 0-14 years and testicular cancer among those aged ≥ 75 years, as well as ASMRs for male bladder cancer aged 15-49 years and testicular cancer aged ≥ 75 years, were higher in China than in the studied regions and countries. The MIRs for genitourinary cancers were generally higher in China. From 1990 to 2021, a notable increase in ASIRs for genitourinary cancers in both sexes, as well as ASMRs for male kidney and prostate cancers, across age groups ranging from 15 to 49 years to ≥ 75 years was observed in China, accompanied by higher AAPCs. The decomposition analysis identified the key population-level contributors to the incidence and mortality trends of genitourinary cancers, highlighting the varying influences of aging, population growth, and epidemiological changes. Smoking-related genitourinary cancer deaths remained high in Chinese males, and mortality related to high body mass index for kidney cancer and elevated fasting plasma glucose levels for bladder cancer also increased.

Conclusions: The distinct age-specific patterns, elevated rates within specific age groups, and marked upward temporal trends of genitourinary cancers in China underscore the critical need for targeted, age-stratified public health interventions.