The global burden of bladder, kidney, and prostate cancers attributable to smoking from 1990 to 2021 and projections for the next two decades: A cross-sectional study

Introduction Smoking increases the risk of bladder and kidney cancers and is associated with a poorer prognosis in prostate cancer (PCa) patients, which poses a significant health and socioeconomic burden. Understanding the epidemiologic trends of urological cancers attributable to smoking is critic...

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Main Authors: Xiangyu Chen<sup>+<sup>, Xuexue Hao<sup>+<sup>, Jinhao Wu<sup>+<sup>, Xiaoqiang Liu
Format: Article
Language:English
Published: European Publishing 2025-05-01
Series:Tobacco Induced Diseases
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Online Access:https://www.tobaccoinduceddiseases.org/The-global-burden-of-bladder-kidney-and-prostate-cancers-attributable-to-smoking,204299,0,2.html
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Summary:Introduction Smoking increases the risk of bladder and kidney cancers and is associated with a poorer prognosis in prostate cancer (PCa) patients, which poses a significant health and socioeconomic burden. Understanding the epidemiologic trends of urological cancers attributable to smoking is critical to developing targeted prevention strategies. This study examines global trends in the three urological cancers attributable to smoking from 1990 to 2021 and projects future trends over the next two decades. Methods Data were obtained from the Global Burden of Disease (GBD) 2021. Metrics included deaths, disability-adjusted life years (DALYs), age-standardized mortality rates (ASMR), and age-standardized DALY rates (ASDR), with uncertainty intervals (UIs). Burden comparisons were stratified by sex, age, and sociodemographic index (SDI). Temporal trends were analyzed using Joinpoint regression to calculate annual percentage change (APC) and average annual percentage change (AAPC), with 95% confidence intervals (CIs). Future trends were predicted using the autoregressive integrated moving average (ARIMA) model. Results Compared with 1990, the number of deaths of bladder cancer, kidney cancer and PCa attributable to smoking increased by 43%, 67%, and 31%, and the number of DALYs increased by 31%, 52%, and 29% in 2021. However, the corresponding age-standardized rates showed a downward trend (AAPC ASMR of bladder cancer , -1.53; AAPC ASDR of bladder cancer , -1.68; AAPC ASMR of kidney cancer , -0.89; AAPC ASDR of kidney cancer , -1.11; AAPC ASMR of PCa , -2.10; AAPC ASDR of PCa , -1.97). The burden was higher among males than females, with the highest burden observed in high-SDI regions. The ASMR and ASDR were found to have a non-linear positive correlation with SDI (R ASMR of bladder cancer =0.574, p<0.001; R ASDR of bladder cancer =0.580, p<0.001; R ASMR of kidney cancer =0.792, p<0.001; R ASDR of kidney cancer =0.783, p<0.001; R ASMR of PCa =0.417, p<0.001; R ASDR of PCa =0.436, p<0.001), although the greatest improvements over the past three decades were observed in high-SDI regions. Joinpoint regression analysis indicated a downward trend in global deaths and DALYs burden, and the ARIMA model predicted that the burden of related diseases will continue to decline through 2041 (ASMR bladder cancer =0.44; ASDR bladder cancer =8.56; ASMR kidney cancer =0.13; ASDR kidney cancer =2.82; ASMR PCa =0.28; ASDR PCa =4.28). Conclusions Smoking has imposed a substantial disease burden on urological cancers over the past three decades. While overall ASDR and ASMR are declining, the disease burden remains high among men, especially those in high-SDI areas. This emphasizes the need for increased tobacco control for these populations or regions.
ISSN:1617-9625