Changing paradigms in female bladder cancer management: global epidemiology and future projections from 1990 to 2040

Bladder cancer remains a significant global health concern, yet gender-specific epidemiological trends remain understudied. This study retrospectively evaluates the global burden of female bladder cancer from 1990 to 2021 and projects future trends to 2040.

Using data from the Global Burden of Disease (GBD) 2021 study, the author assessed prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for female bladder cancer across 204 countries and territories. Age-standardized rates (ASRs) were calculated using the GBD world standard population. Temporal trends were quantified via Estimated Annual Percentage Change (EAPC), with joinpoint regression identifying significant transitions. Risk factor attributions were modeled using comparative risk assessment. Bayesian age-period-cohort analysis projected future disease burden, validated against alternative forecasting models.

From 1990 to 2021, female bladder cancer prevalent cases increased by 108.3%, yet age-standardized prevalence rates declined slightly (EAPC: - 0.18). Mortality increased by 69.4%, with age-standardized death rates (ASDR) decreasing (EAPC: - 1.25). Joinpoint analysis revealed a significant slowdown in mortality decline after 2012. High-SDI regions showed the highest ASPR (30.9/100,000) but slowest mortality decline (EAPC: - 0.94). Tobacco accounted for 10.4% of deaths, peaking in High-income North America (21.8%). Projections suggest continued declines in ASIR (-11.7% by 2040) and ASPR (-11.8%), but mortality reductions may plateau (ASDR decline slows to -1.5% by 2024).

While age-standardized rates for female bladder cancer are declining globally, absolute case continue rising due to population growth and aging. The projected mortality plateau signals limitations in current therapeutic approaches. Persistent disparities across SDI regions and substantial tobacco-attributable burden highlight the need for targeted interventions. Enhanced early detection and therapeutic innovation are crucial to address impending challenges in female bladder cancer control.