Overview: the rising global impact of kidney cancer
Kidney cancer, though not the most common cancer by incidence, poses a substantial global health challenge due to its mortality and disability burden. Recent analyses based on the Global Burden of Disease (GBD) 2021 dataset reveal that from 1990 to 2021 the world experienced a marked increase in kidney cancer incidence, prevalence, mortality, and disability-adjusted life years (DALYs). The burden is not uniform: higher in men than women, and variably distributed across regions and socioeconomic development levels, with notable rise in many middle- and high-income settings and persistent disparities in lower-SDI regions.
What the data show: incidence, mortality, and DALYs in 2021
In 2021, global kidney cancer incidence reached about 390,000 new cases, while mortality and DALYs rose to roughly 160,000 deaths and 4.0 million DALYs, respectively. The age-standardized rates (ASRs) for incidence, mortality, and DALYs remain higher in men than in women, reflecting sex-based differences in exposure to risk factors such as tobacco use and obesity. Within countries, China and the United States reported the largest numbers of incident cases, but regional patterns differ: Argentina showed the highest age-standardized incidence rate, and Uruguay retained high mortality and DALY rates, underscoring heterogeneity in healthcare access and diagnostic capabilities.
Regional and socioeconomic disparities: the role of SDI
The burden varies strongly with sociodemographic development. Across SDI strata, burden generally climbs with higher SDI in terms of absolute numbers, but mortality and DALYs have declined in several high-SDI regions thanks to early detection and advanced treatments. In contrast, middle- and low-SDI regions faced faster growth in incidence and particularly mortality, translating into higher mortality-to-incidence ratios (MIRs). This suggests that improvements in diagnosis and treatment have not been evenly distributed globally, prompting a need for targeted policy responses.
Risk factors driving the burden
Key modifiable drivers identified in the analysis include high body mass index (BMI) and tobacco smoking, which contribute substantially to kidney cancer mortality and DALYs, particularly in higher-SDI contexts where data are more robust. Occupational exposure to trichloroethylene also contributes but to a smaller extent. Obesity, in particular, is rising in many low- and middle-SDI countries, intensifying future risk if preventive measures are not implemented. These findings support diversified prevention strategies that align with regional development and lifestyle patterns.
Forecasts to 2046: what APC and BAPC models reveal
To project future trends, the study applied both classical age–period–cohort (APC) and Bayesian APC (BAPC) models. Across most scenarios, projected age-standardized rates trend downward gradually, suggesting that mortality and DALYs may decline as treatment improves. However, the absolute burden is expected to rise in many regions due to aging populations and population growth, underscoring the ongoing public health impact. Notably, the Bayesian approach yields smoother, more stable long-term trajectories, particularly in data-sparse settings, and aligns with policy needs for planning in low-resource environments.
Implications for health policy and resource allocation
The integrated analysis highlights the value of SDI-stratified planning. High-SDI countries should continue prioritizing early detection and access to targeted therapies, while low- and middle-SDI regions require strengthened cancer registries, diagnostic capacity, and affordable treatment options. Public health campaigns focused on obesity prevention and smoking cessation can yield meaningful reductions in burden, especially where BMI and smoking are rising. Policymakers should also invest in surveillance and data quality to reduce uncertainty in future projections and to tailor interventions to local risk profiles.
Limitations and opportunities for future research
GBD-based estimates depend on the quality of country-level data. Underdiagnosis and incomplete registration in lower-SDI settings may bias results, and some etiologic factors (e.g., hypertension, CKD) are not fully captured in all CRA risk-outcome pairs. Ongoing improvement of cancer registries, harmonized surveillance, and regional modeling will enhance the precision of burden estimates and the effectiveness of prevention strategies.
Conclusion
Between 1990 and 2021 kidney cancer burden rose globally, with substantial regional and socioeconomic variation. Projections up to 2046 indicate that while rates may gradually decline, the absolute burden will remain non-trivial due to aging and population growth. A targeted, SDI-informed strategy—prioritizing obesity control, smoking cessation, and strengthened healthcare systems in lower-SDI regions—will be essential to reduce the future impact of kidney cancer on global health.
