A retrospective observational analysis of the global burden of smoking-attributable prostate, bladder, and kidney cancers among adults aged 40 years and older: Based on the global burden of disease study 2021 with projections to 2045.

内容摘要

ObjectiveSmoking remains a significant risk factor for prostate, bladder, and kidney cancers. The disease burden and smoking-attributable carcinogenic effects are particularly concentrated in adults aged 40 years and older, making this age group critical for targeted prevention. We aimed to analyze the global, regional, and national disease burden of smoking-attributable prostate, bladder, and kidney cancers exclusively among adults aged 40 years and older from 1990 to 2021, and to provide long-term projections to 2045 for evidence-based tobacco control and cancer prevention strategies.MethodsThis retrospective observational study used data from the Global Burden of Disease Study 2021, we assessed age-standardized mortality rate (ASMR) and disability-adjusted life year rate (ASDR), along with absolute deaths and disability-adjusted life years (DALYs). Trends were evaluated using estimated annual percentage change (EAPC), and future burden was projected using the Nordpred model.ResultsFrom 1990 to 2021, absolute DALYs and deaths increased globally, while ASDR and ASMR declined. In 2021, DALYs for prostate and kidney cancers peaked at ages 65-69, and for bladder cancer at 70-74. High-SDI regions had the highest ASDR for prostate and kidney cancers, while middle-high-SDI regions led in bladder cancer. ASDR and ASMR decreased for prostate and bladder cancers across most SDI regions, but kidney cancer rates rose in Middle and Low-middle-SDI regions. By 2045, prostate cancer ASDR/ASMR are projected to increase after 2035, while bladder and kidney cancers will continue declining, though absolute burden will rise.ConclusionSmoking-attributable urological cancers remain a major public health challenge. Despite declining age-standardized rates, absolute burden is growing, particularly among older adults and in middle/low-SDI regions. Strengthened tobacco control, early screening, and optimized resource allocation are critical to reducing future burden.