Three-decade trends in bladder cancer burden in the Middle East and North Africa: Divergent patterns between regional and Saudi Arabian populations.

e16616 Background: Urinary bladder cancer (UBC) represents a significant public health challenge in the Middle East and North Africa (MENA) region, with age-standardized incidence rates substantially exceeding global averages. Despite this burden, regional epidemiological data remain limited, and the evolving trends in Saudi Arabia have not been systematically compared to broader MENA patterns. This study leverages Global Burden of Disease (GBD) data to characterize longitudinal trends in UBC mortality, incidence, and prevalence across the MENA region and Saudi Arabia from 1990 to 2023. Methods: Age-standardized rates for UBC mortality, incidence, and prevalence were extracted from the GBD 2023 database for the MENA region and Saudi Arabia, stratified by sex. Trends were analyzed using joinpoint regression to calculate annual percentage changes (APC) and average annual percentage changes (AAPC). Pairwise comparisons between MENA and Saudi Arabia trends were performed to assess statistical significance. Results: In MENA, mortality declined from 4.01 to 3.55 per 100,000 (AAPC: -0.40%), incidence increased from 6.85 to 7.44 (AAPC: 0.16%), and prevalence rose from 29.71 to 37.70 (AAPC: 0.71%). In Saudi Arabia, mortality decreased from 4.96 to 3.73 (AAPC: -0.86%), with divergent sex trends: male mortality declined (AAPC: -1.20%) while female mortality increased (AAPC: 0.50%). Saudi incidence remained stable (AAPC: -0.12%) while prevalence increased (AAPC: 0.48%). Males had 3-4 times higher rates than females. MENA mortality declined until 2010 then reversed; incidence increased after 2009. Trends differed significantly between regions (p < 0.001). By 2050, MENA mortality is projected to decline 5.0% while Saudi Arabia mortality increases 7.65%. Conclusions: While UBC mortality has declined modestly in both MENA and Saudi Arabia over the past three decades, rising incidence and prevalence rates underscore a growing disease burden. The marked divergence in temporal trends between Saudi Arabia and the broader MENA region, along with notable sex-specific disparities—particularly the increasing female mortality and incidence in Saudi Arabia—highlight the need for tailored public health interventions. These findings emphasize the importance of strengthening regional cancer surveillance, enhancing early detection programs, and implementing targeted tobacco control and metabolic health initiatives to address the evolving epidemiological landscape of bladder cancer in the region.