Global, regional, and national burden of kidney cancer, 1990 to 2021, and projections to 2050: A Global Burden of Disease Study 2021

Although the Global Burden of Disease Study (GBD) 2019 offered important insights into kidney cancer, no research has yet examined the updated GBD 2021. Therefore, utilizing the GBD 2021, this study provides updated estimates of kidney cancer burden, identifies attributable risk factors, and projects future trends through 2050. Data on the global and regional burden of kidney cancer from 1990 to 2021 were extracted from the GBD 2021, stratified by age, sex, Sociodemographic Index (SDI), and geographical region. Mortality-to-incidence ratio and annual percentage changes on mortality, disability-adjusted life year (DALY), and incidence were analyzed to assess trends of the burden. Attributable risk factors (i.e., tobacco use, high body mass index, and occupational risks) were examined. Additionally, future mortality and DALYs up to 2050 were forecasted by integrating independent drivers, with analyses conducted under a baseline scenario and an improved scenario with enhanced behavioral and metabolic risk factors. In 2021, kidney cancer caused 161.19 thousand (95% uncertainty interval, 150.32-169.35) deaths, 4.02 million (3.81-4.25) DALYs, 387.83 thousand (365.36-406.64) incident cases, and 0.42 (0.39-0.46) mortality-to-incidence ratio globally. While the absolute burden of kidney cancer increased from 1990 to 2021, age-standardized rates decreased. The burden was higher in males, older populations, and regions with higher SDI, although recent declines in these regions contrast with rising burden in lower SDI regions. High body mass index was the leading risk factor, particularly in females, while tobacco was more prominent in males. By 2050, the global age-standardized DALY rate is projected to rise slightly to 47.72 (35.89-63.05) per 100,000. However, under a scenario with improved behavioral and metabolic risks, it is expected to decline to 35.86 (26.71-48.11), except in South Asia and Sub-Saharan Africa. Addressing sociodemographic disparities in kidney cancer burden and strengthening global efforts are essential. Managing behavioral and metabolic risks could reduce the kidney cancer burden.