Socioeconomic inequalities in the epidemiological landscape of genitourinary cancers: a GLOBOCAN 2024 analysis

Background Given the poor prognosis and marked geographic and socioeconomic inequalities in the burden of genitourinary cancers, updating the global epidemiological landscape is essential for informing region-specific and equity-oriented strategies. Methods Using GLOBOCAN 2024, we estimated age-standardized incidence (ASIR), mortality (ASMR), and 1−mortality-to-incidence ratio (1−M/I) for genitourinary cancers. Socioeconomic inequalities across Human Development Index (HDI) levels were quantified using the slope index of inequality (SII) and concentration index (ConI). We further decomposed factors contributing to these inequalities and estimated population attributable fractions (PAFs) for selected modifiable risk factors under specified counterfactual scenarios. Results In 2024, the global ASIR and ASMR of genitourinary cancers were 35.97 and 9.85 per 100,000, respectively, with a 1−M/I of 0.73. ASIRs were the highest in Northern America, Europe, and Australasia, whereas ASMRs peaked in Caribbean and African regions. ASIR and 1−M/I were substantially higher in very-high-HDI than low-HDI countries (ASIR: 71.07 vs 25.72 per 100,000; 1−M/I: 0.82 vs 0.40 per 100,000). Significant inequalities were observed for ASIR (SII: 62.15; ConI: 0.24) and 1−M/I (SII: 0.51; ConI: 0.14). Education, income, universal health coverage, and health expenditure were major contributors. Globally, Particulate Matter 2.5 showed the largest estimated PAFs for kidney (24.09%–28.53%) and bladder cancers (20.86%–24.52%) under alternative counterfactual exposure levels. The HIV-associated PAF for penile cancer was 2.82% globally and 10.64% in low-HDI countries, indicating marked heterogeneity across cancer types and HDI levels. Conclusions Genitourinary cancers exhibit geographic and socioeconomic inequalities, with pronounced heterogeneity in potentially attributable burden across modifiable risk factors and HDI levels. These findings support context-specific prevention and health-system strategies.