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. 2020 Aug 17;10(1):13862.
doi: 10.1038/s41598-020-70840-2.

The burden of kidney cancer and its attributable risk factors in 195 countries and territories, 1990-2017

Saeid Safiri  1   2   3 , Ali-Asghar Kolahi  4 , Mohammad Ali Mansournia  5 , Amir Almasi-Hashiani  6 , Ahad Ashrafi-Asgarabad  7 , Mark J M Sullman  8   9 , Deepti Bettampadi  10   11 , Mostafa Qorbani  12 , Maziar Moradi-Lakeh  13 , Mohammadreza Ardalan  14 , Ali Mokdad  15 , Christina Fitzmaurice  15   16
Affiliations

The burden of kidney cancer and its attributable risk factors in 195 countries and territories, 1990-2017

Saeid Safiri et al. Sci Rep. .

Abstract

Kidney cancer globally accounts for more than 131,000 deaths each year and has been found to place a large economic burden on society. However, there are no recent articles on the burden of kidney cancer across the world. The aim of this study was to present a status report on the incidence, mortality and disability-adjusted life years (DALYs) associated with kidney cancer in 195 countries, from 1990 to 2017. Vital registration and cancer registry data (total of 23,660 site-years) were used to generate the estimates. Mortality was estimated first and the incidence and DALYs were calculated based on the estimated mortality values. All estimates were presented as counts and age-standardised rates per 100,000 population. The estimated rates were calculated by age, sex and according to the Socio-Demographic Index (SDI). In 2017, kidney cancer accounted for 393.0 thousand (95% UI: 371.0-404.6) incident cases, 138.5 thousand (95% UI: 128.7-142.5) deaths and 3.3 million (95% UI: 3.1-3.4) DALYs globally. The global age-standardised rates for the incidence, deaths and DALY were 4.9 (95% UI: 4.7-5.1), 1.7 (95% UI: 1.6-1.8) and 41.1 (95% UI: 38.7-42.5), respectively. Uruguay [15.8 (95% UI: 13.6-19.0)] and Bangladesh [1.5 (95% UI: 1.0-1.8)] had highest and lowest age-standardised incidence rates, respectively. The age-standardised death rates varied substantially from 0.47 (95% UI: 0.34-0.58) in Bangladesh to 5.6 (95% UI: 4.6-6.1) in the Czech Republic. Incidence and mortality rates were higher among males, than females, across all age groups, with the highest rates for both sexes being observed in the 95+ age group. Generally, positive associations were found between each country's age-standardised DALY rate and their corresponding SDI. The considerable burden of kidney cancer was attributable to high body mass index (18.5%) and smoking (16.6%) in both sexes. There are large inter-country differences in the burden of kidney cancer and it is generally higher in countries with a high SDI. The findings from this study provide much needed information for those in each country that are making health-related decisions about priority areas, resource allocation, and the effectiveness of prevention programmes. The results of our study also highlight the need for renewed efforts to reduce exposure to the kidney cancer risk factors and to improve the prevention and the early detection of this disease.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
The age-standardised incidence (a) and death (b) rates of kidney cancer in 2017 for the 21 GBD regions by sex.
Figure 2
Figure 2
The percentage change in the age-standardised incidence (a) and death (b) rates of kidney cancer from 1990 to 2017 for the 21 GBD regions by sex.
Figure 3
Figure 3
Number of incident cases (a) and deaths (b) of kidney cancer from 1990 to 2017 for the 21 GBD regions.
Figure 4
Figure 4
Age-standardised incidence rate (per 100,000 population), by country, for 2017. ATG Antigua and Barbuda, VCT Saint Vincent and the Grenadines, BRB Barbados, COM Comoros, DMA Dominica, GRD Grenada, MDV Maldives, MUS Mauritius, LCA Saint Lucia, TTO Trinidad and Tobago, TLS Timor-Leste, SYC Seychelles, MLT Malta, SGP Singapore, MHL Marshall Islands, KIR Kiribati, SLB Solomon Islands, FSM Federated States of Micronesia, VUT Vanuatu, WSM Samoa, FJI = Fiji, TON Tonga. Maps were generated using R software version 3.5.2. (R Core Team (2019). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/).
Figure 5
Figure 5
Age-standardised death rate (per 100,000), by country, for 2017. ATG Antigua and Barbuda, VCT Saint Vincent and the Grenadines, BRB Barbados, COM Comoros, DMA Dominica, GRD Grenada, MDV Maldives, MUS Mauritius, LCA Saint Lucia, TTO Trinidad and Tobago, TLS Timor-Leste, SYC Seychelles, MLT Malta, SGP Singapore, MHL Marshall Islands, KIR Kiribati, SLB Solomon Islands, FSM Federated States of Micronesia, VUT Vanuatu, WSM Samoa, FJI Fiji, TON Tonga. Maps were generated using R software version 3.5.2. (R Core Team (2019). R: A language and environment for statistical computing. R Foundation for Statistical Computing, Vienna, Austria. https://www.R-project.org/).
Figure 6
Figure 6
Global number of incidents and age-standardised incidence rate of kidney cancer per 100,000 population by age and sex, 2017; Dotted and dashed lines indicate 95% upper and lower uncertainty intervals, respectively.
Figure 7
Figure 7
Age-standardised DALY rates for kidney cancer for the 21 Global Burden of Disease regions by Socio-demographic Index, 1990–2017; Expected values based on Socio-demographic Index and disease rates in all locations are shown as the black line. For each region, points from left to right depict estimates from each year from 1990 to 2017. DALY disability-adjusted life-year.
Figure 8
Figure 8
Age-standardised DALY rates of kidney cancer in 195 countries and Socio-demographic Index, 2017; Expected values are shown as the black line. DALY disability-adjusted life-year.
Figure 9
Figure 9
Percent of kidney cancer DALYs attributable to risk factors for the 21 Global Burden of Disease regions in 2017. DALY disability-adjusted life-year.
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