The burden of bladder cancer in Africa: a 2024 GLOBOCAN-based study with projections to 2050

Abstract Background Bladder cancer is a significant global health concern with substantial variations in burden geographically. In Africa, distinctive epidemiology determines the pattern of incidence of bladder cancer in addition to typical risk factors and given the evolving demographic landscape, it is necessary to provide an update of the current and projected burden of disease to guide policy making in resource allocation and planning of cancer control. Methods Using data from GLOBOCAN 2024 estimates, this study describes bladder cancer incidence and mortality across all 54 African Union member states, grouped into the five UN subregions (Northern, Western, Middle, Eastern, and Southern Africa). The data used were extracted independently by two authors into a structured workbook, recording case counts, deaths, age-standardized rates (ASR), crude rates, cumulative risk, and data-source quality. Results In 2024, an estimated 33,477 new bladder cancer cases and 18,626 deaths occurred across Africa. Northern Africa carried the highest burden, accounting for 54.4% of cases and 54.7% of deaths, with the highest ASR for incidence (7.9) and mortality (4.5); Egypt recorded the highest national rates (11.4 and 6.4 respectively). The male-to-female incidence ratio was higher in all subregions, most notably in Northern Africa (4.5:1), than in Middle Africa (1.7:1), while the male-to-female mortality ratio showed a similar trend in most subregions. Continental incidence is expected to increase by 133.0% and mortality by 138.0% by 2050, which is probably due to population growth and ageing. Eastern Africa is projected to see the largest relative increase in incidence (+ 159.3%) and mortality (+ 168.5%) while Northern Africa is projected to have the most absolute burden. Conclusion Bladder cancer in Africa follows a distinct geographic pattern, with Northern African bearing the highest current burden, largely attributable to historical schistosomiasis endemicity, alongside a marked male predominance in exposure. The projected disproportionate rise in regions with less developed oncological infrastructure signals the need for early investment in increased capacity to diagnose, treat and control cancer, as well as strengthening infrastructure for schistosomiasis control, tobacco-control interventions and cancer-registry creation in the region.