Kidney cancer in Eastern Mediterranean Region and Qatar: epidemiological burden patterns and etiologic risk pathways

Abstract Kidney cancer contributes substantially to the global cancer burden, with significant geographic and sex differences. Countries in the Eastern Mediterranean Region (EMR) show rising incidence and mortality alongside gaps in registry coverage and high prevalence of metabolic risks. Qatar, though small, reports one of the region’s highest age-standardised incidence rates. A purposeful, structured narrative review (from database inception to June 2025) was conducted across MEDLINE/PubMed, EMBASE and CINAHL, triangulated with authoritative population databases (GLOBOCAN 2022, GBD 2021, WHO/EMRO) and national registry reports. Epidemiological evidence and risk factors, along with their magnitudes, were compiled, analyzed and interpreted narratively and synthesized according to WCRF/AICR and IARC grading. Incidence and mortality are increasing in several regions; growth in EMR outpaces many WHO regions. Men have higher rates than women, and the risk escalates with age. Established/probable drivers include excess body fatness (~ 30% higher risk per + 5 kg/m²), tobacco smoking (1.3 current vs. never), hypertension (1.6-2.0), chronic kidney disease, particularly dialysis with acquired cystic disease (2–3 times), occupational trichloroethylene exposure (1.3 to 1.4, higher at intense exposure), diabetes (1.3 to 1.4) and adult height (1.3 per + 10 cm). EMR countries show high prevalence of obesity, raised blood pressure and hyperglycemia. Furthermore, registry system fragmentation and inequity in access, coverage and vital status linkage vary. Qatar mirrors these signals and has an active biobank/genome programme that can support precision epidemiology. An EMR/Qatar-centred synthesis of burden and risk pathways highlights actionable priorities for surveillance and prevention, cardiometabolic risk control, tobacco/waterpipe control, CKD/dialysis surveillance, and solvent-exposure hygiene, and the need to strengthen registry completeness and migrant vital-status linkage.