The Burden of Genitourinary Malignancies in Southeast Asia from 1990 to 2021

Abstract

Background and objective: The global burden of genitourinary (GU) cancers is rising; yet, the specific burden on the diverse population of 700 million in Southeast Asia (SEA) remains poorly understood. This study presents the most updated trends in the incidence and mortality of bladder, kidney, prostate, and testicular cancer patients across SEA from 1990 to 2021.

Methods: Data from the Global Burden of Disease 2021 database were analyzed for the incidence, deaths, and age-standardized rates by sex and age of patients with four major GU cancers across 11 SEA countries from 1990 to 2021.

Key findings and limitations: GU cancer incidence and mortality in SEA primarily increased from 1990 to 2021. Kidney cancer showed the greatest rise in incidence and deaths for both sexes, while prostate cancer had the largest absolute increase in male incidence and mortality. In 2021, Brunei had the highest age-standardized incidence rate (ASIR) and age-standardized mortality rate (ASMR) of kidney cancer for both sexes. Singapore had the highest prostate cancer ASIR, with the incidence rising in all countries except in Laos, and the Philippines recorded the highest ASMR. For bladder cancer, Thailand and Brunei recorded the highest ASIR for males and females, respectively, while Malaysia had the highest male ASMR and Brunei the female ASMR. Testicular cancer ASIR was highest in Singapore; however, ASMR in Singapore decreased over the study period, but increased or remained stable across the region.

Conclusions and clinical implications: Broadly, the rising age-standardized incidence of GU cancers in SEA reflects not only the evolving patterns of modifiable and nonmodifiable risk factors, but also the development of cancer diagnostic systems and improvements in reporting infrastructure. For many SEA countries, these increases warrant enhanced resource allocation for cancer system strengthening, to support timely diagnosis and equitable access to affordable, effective treatment. Regional and international collaboration is essential to promote equity in access to cancer care in SEA.

Keywords: Bladder cancer; Disability-adjusted life years; Disparities; Genitourinary malignancies; Incidence; Kidney cancer; Mortality; Prostate cancer; Southeast Asia; Testicular cancer.