The rising burden of male genitourinary cancers in middle- and high-income countries

Introduction Male genitourinary cancers (prostate, bladder, kidney, and testicular) represent a major cancer burden in middle- and high-income countries (MHIC). We aimed to characterize their distribution and trends across 174 countries using the 2023 Global Burden of Disease (GBD) database. Methods This study presented the incidence, mortality, disability-adjusted life years (DALYs), and age-standardized rates for four male genitourinary cancers by age and location from 1990 to 2023. Average annual percent changes (AAPCs) and Bayesian Age-Period-Cohort (BAPC) models were utilized to quantify temporal dynamics and project trends to 2050. Results In 2023, an estimated 2.16 million new cases and 0.73 million deaths were attributed to male genitourinary cancers in MHIC. From 1990 to 2023, age-standardized incidence rates (ASIRs) increased for PCa, KCa, and TCa across all income groups. However, age-standardized mortality rates (ASMRs) exhibited divergent trends: declining significantly in high-income countries (HC) while remaining stable or increasing in lower-middle-income countries (LMC). Smoking remained the predominant risk factor, though metabolic factors (high BMI, hyperglycemia) demonstrated increasingly prominent population-attributable fractions in wealthier nations. Projections to 2050 suggest a growing burden in LMC and upper-middle-income countries (UMC). Conclusion The marked increase in ASIRs in wealthier nations partially reflects superior diagnostic capacity (e.g., PSA screening) rather than exclusively a true increase in disease burden. The divergence between rising incidence and persistently high mortality in LMC highlights the urgent need for tailored, resource-stratified public health strategies.