Global Burden of Major Urologic Diseases in Women, 1990–2021: A Systematic Analysis for the Global Burden of Disease Study 2021

Junyi Zhang,1,* Junxiao Shen,2,* Zujie Chen,2,* Luyuan Lu,1 Jianwei Wang1,3 1Department of Surgery, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, Zhejiang, People’s Republic of China; 2Department of Urology, The Fourth Affiliated Hospital of School of Medicine, and International School of Medicine, International Institutes of Medicine, Zhejiang University, Yiwu, Zhejiang, People’s Republic of China; 3Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, People’s Republic of China*These authors contributed equally to this workCorrespondence: Jianwei Wang, Department of Colorectal Surgery and Oncology, Key Laboratory of Cancer Prevention and Intervention, Ministry of Education, 2nd Affiliated Hospital, Zhejiang University School of Medicine, Jiefang Road 88th, Hangzhou, Zhejiang, 310009, People’s Republic of China, Email [email protected]: The global health burden faced by women remains underappreciated, particularly with regard to urologic diseases.Purpose: This study aims to assess the patterns and temporal trends of four major urinary conditions in women including urinary tract infections (UTIs), urolithiasis, kidney cancer, and bladder cancer from 1990 to 2021.Patients and Methods: We obtained data from the Global Burden of Disease (GBD) Study 2021, which provides estimates of incidence and disability-adjusted life years (DALYs) for urologic diseases in women across 204 countries and territories from 1990 to 2021. To assess temporal trends, we calculated the estimated annual percentage change (EAPC) in age-standardized incidence rates (ASRs) by region. Age-specific patterns were further evaluated through stratified analyses of incidence and DALYs across the life course.Results: In 2021, the global incidence of urologic diseases in women continued to rise. Country- and region-specific analyses revealed diverse trends in incidence rates and DALYs. Analysis of the EAPC in 2021 showed a positive correlation between the age-standardized death rate (ASDR) of UTIs and the Human Development Index (HDI), whereas bladder cancer ASDR was negatively correlated with HDI. Risk factor analysis indicated that smoking and poor metabolic health exacerbate the burden of kidney and bladder cancers. Additionally, both DALYs and incidence rates varied markedly across age groups. While the age-standardized incidence rates (ASIR) and ASDR for urolithiasis remained relatively stable over time, UTIs, as well as kidney and bladder cancers showed a slight increase projected beyond 2032.Conclusion: The burden of four major urologic diseases in women constitutes a significant global public health challenge. The diverse disease patterns underscore the importance of developing tailored, country-specific prevention and healthcare strategies based on local risk factor profiles. Our findings offer critical evidence to guide targeted public health policies.Keywords: global burden of disease study, urologic disease, urinary tract infection, urolithiasis, kidney cancer, bladder cancer