Sex-specific divergence in global urological cancer trajectories to 2050: A dual-model projection analysis based on...

Urological malignancies are major contributors to the global cancer burden. This study aims to provide a comprehensive, sex-stratified assessment of the 2022 baseline and project trajectories to 2050 for prostate, bladder, and kidney cancers to inform long-term surgical oncology and healthcare planning.

Baseline estimates for 185 countries were retrieved from GLOBOCAN 2022, with longitudinal trends from GBD 2021. We employed a dual-modeling framework: demographic forecasting for absolute case volumes and Bayesian Age-Period-Cohort (BAPC) models for age-standardized risk trends (ASIR/ASMR), including 95% uncertainty intervals (UI).

In 2022, urological cancers accounted for 2.52 million new cases and 773,968 deaths globally. While prostate cancer dominated male burden, bladder and kidney cancers posed a notable clinical demand in both sexes. Higher HDI correlated with higher ASIR but lower mortality-to-incidence (M:I) ratios. A critical sex-specific divergence was observed: BAPC models predicted risk declines in females, but stable or modestly rising risks in males through 2050, likely driven by escalating metabolic factors. Paradoxically, the absolute global burden is projected to increase by 92.5%, reaching 4.85 million cases and 1.74 million deaths annually by 2050. The sharpest relative increases (>100%) are expected in low-to-medium HDI regions, where mortality growth is projected to outpace incidence.

The urological cancer landscape faces a dual challenge of population aging and stagnating male-specific risks. Our findings describe an urgent need to expand urological surgical capacity and infrastructure, particularly in transitioning economies, to accommodate the inevitable surge in operative demand despite favorable risk trends in specific populations.