Systematic Analysis of the Global, Regional and National Burden of Kidney Cancer from 1990 to 2017: Results from the Global Burden of Disease Study 2017

Abstract

Background

Data on kidney cancer burden are valuable for health-related policy making.

Objective

To report the results of the Global Burden of Disease 2017 study on global kidney cancer burden estimates grouped by gender, age, region, country or territory, and sociodemographic index (SDI) from 1990 to 2017.

Design, setting, and participants

This study is based on the Global Burden of Disease database.

Outcome measurements and statistical analysis

We report here detailed estimates and temporal trends of the burden estimates of kidney cancer from 1990 to 2017, stratified by gender and age, in 195 countries and territories. We further evaluated the relationship between these estimates and the SDI, a composite indicator of income per person, years of education, and fertility as a measurement of the socioeconomic level of a country/region. The percentage change and estimated annual percentage change of incidence, mortality, and disability-adjusted life years (DALYs) were calculated to quantify temporal trends.

Results and limitations

Globally, age-standardized incidence rates, age-standardized death rates, and DALYs of kidney cancer in males exhibited an increase of 0.387%/yr, 0.345%/yr, and 0.046%/yr, respectively, from 1990 to 2017. This trend was mainly due to the increase in middle and low-middle SDI quintile countries. However, in females, decreasing trends of –0.324%/yr, –0.330%/yr, and –0.669%/yr, respectively, were observed. These trends were mainly due to the decrease in high, high-middle, and middle SDI quintile countries. Study limitations included differences in data collection practices, coding systems, and quality of data sources.

Conclusions

The burden estimate pattern of kidney cancer trends varies widely between genders and throughout the world. Low-middle and middle SDI quintile countries face the highest burden estimates, especially for males. Efforts to increase health care investment are needed in these countries.

Patient summary

The global burden estimate of kidney cancer trends increased in males; however, it decreased in females.

Introduction

The prevalence of kidney cancer (KC) is increasing with the expansion and increasing age of the world’s population. KC represents 2–3% of all cancers [1] and is the 13th most common cancer worldwide, and >330 000 new cases are diagnosed each year [2]. It was ranked as the 16th most common cause of death from cancer worldwide in 2012 [3]. The epidemiology of KC varies globally based on gender, age, geography, and economic status. It is the ninth most common cancer in men and the 14th most common cancer in women. KC is more likely to affect elderly individuals. The highest incidence is in developed countries such as North America and Europe, and the lowest rates are in Asia and Africa [4]. The annual economic burden of KC was $5.2 billion in the USA in 2009 and continues to rise every year, especially with the use of targeted therapy [5]. Therefore, KC imposes a significant financial burden on individuals and health care systems. However, the same level of public health attention has not been paid to KC [6].

Understanding the epidemiology of KC among different regions/nations and changing trends is crucial for prevention, early diagnosis, and treatment. Moreover, precise and reliable reports on patterns and disease trends in different geographical areas provide policy makers with the evidence needed to allocate resources appropriately. However, most epidemiological studies of KC have been based on general practice surveys, selected population surveys, or hospital data. Few evaluations have been performed at the national level, and there is currently no study specifically addressing trends in the disease burden of KC at a global level stratified by the sociodemographic index (SDI). Therefore, current studies are inadequate for determining the true demographic status in a nation. Furthermore, comparisons between different nations and a chronological assessment are also impossible. The Global Burden of Disease (GBD) study assessed the KC burden in 195 countries and territories worldwide, providing a unique opportunity to understand the global burden of this disease. It provides a comprehensive assessment of changes in disease health status by synthesizing many types of data, which are freely available to policy makers and public groups seeking to improve human health [7]. Here, based on the GBD 2017 study, we report an in-depth examination of the global burden of KC from 1990 to 2017 and investigate the disease burden to determine temporal trends of these estimates at global, regional, and national levels. The relationships of estimates of the global burden of KC with SDI, gender, and age were further assessed.