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Trends of kidney cancer burden from 1990 to 2019 in European Union 15 + countries and World Health Organization regions

Trends in KC among EU15 + countries were analyzed from 1990 to 2019. Age-adjusted incidence and mortality rates, mortality-incidence ratios, and age-standardized DALYs were compared in this study.

Trends in KC ASIR, 1990–2019

Across the study period, there was a rise in ASIR globally for both males (+ 38.4%) and females (+ 13.5%). There was a similar trend across all six regions, with the Western Pacific region seeing the greatest increase in males (+ 142.8%), while the Eastern Mediterranean region saw the greatest increase in females (+ 98.4%). The Americas had the smallest increase in ASIR for males (+ 16.4%) and was the only region to observe a fall in ASIR for females (− 6.9%).

Amongst EU 15 + countries, Denmark had the greatest increase in ASIR for both males and females, + 89.3 and 82.8%, respectively. Austria was among the only three countries witnessing a fall in ASIR for males and saw the greatest fall (− 18.0%). Sweden saw the greatest fall in ASIR for females (− 24.0%).

Tables 1 and 2 and, Figs. 1, 2 depict gender-specific trends in KC ASIR across EU 15 + countries and 6 WHO regions.

Table 1 1990 and 2019 female age-standardized mortality rates (ASMRs), age-standardized incidence rates (ASIRs), mortality-to-incidence ratios (MIR), and disability-adjusted life years (DALYs), with associated percentage changes, for KC in the European Union 15 + countries and WHO regions.
Table 2 1990 and 2019 male age-standardized mortality rates (ASMRs), age-standardized incidence rates (ASIRs), mortality-to-incidence ratios (MIR), and disability-adjusted life years (DALYs), with associated percentage changes, for KC in the European Union 15 + countries and WHO regions.
Figure 1
figure 1

Age-standardized incidence rates (ASIR) for females (a) and males (b), age-standardized mortality rates for females (ASMR) (c) and males (d), mortality-to-incidence ratios (MIR) for females (e) and males (f), and disability-adjusted life years (DALYs) for females (g) and males (h) for kidney cancer (KC) for EU 15 + countries in 2019. All indices are per 100,000 population.

Figure 2
figure 2

Age-standardized incidence rates (ASIR) for males (a) and females (b), age-standardized mortality rates for males (ASMR) (c) and females (d), mortality-to-incidence ratios (MIR) for males (e) and females (f) and disability-adjusted life years (DALYs) for males (g) and females (h) for kidney cancer (KC) for WHO regions in 2019. All indices are per 100,000 population. The figure is created by Dr. Chinmay Jani with mapchart.net (URL: https://www.mapchart.net/) and is licensed under the Creative Commons Attribution-ShareAlike 4.0 International License.

The Joinpoint analyses for ASIR in males and females are shown in Table 3 and Fig. 3

Table 3 Joinpoint analysis for KC age-standardized incidence rates in EU15 + countries and WHO regions for years 1990–2019 in males (A), females (B).
Figure 3
figure 3

Trends in age-standardized incidence rates (ASIR) per 100,000 for KC in EU15 + countries and WHO regions between 1990 and 2019. Open squares indicate males; and filled circles, females.

Global ASIR for males increased between 1990 and 1994 (EAPC 2.6 [2.1–3.2]), but from 1994 to 1997, the change was not statistically significant (EAPC: 0.8 [− 1.0 to 2.5]). Between 1997 and 2009, the ASIR increased again (EAPC; 1.6 [1.4–1.7]), and since 2009, the trajectory in ASIR has been mostly flat (EAPC 0.1 [− 0.1 to 0.2]). Amongst EU15 + countries, recent trends have been mostly flat or negative. Most recently, the greatest increase has been observed in the UK between 2006 and 2019 (EAPC: 0.6 [0.5–0.7]). The greatest decrease has been observed in Norway between 2011 and 2019 (EAPC: − 2.1 [− 2.6 to − 1.5]).

The rate of increase in ASIR has been variable amongst the WHO regions. Between 2011 and 2019, the Eastern Mediterranean region observed the greatest increase in ASIR (EAPC: 3.1 [2.9–3.3]). Conversely, the Americas have seen the slowest rate of increase between 2002 and 2019 (EAPC: 0.1 [0.1–0.2]).

Global ASIR for females increased between 1990 and 1993 (EAPC; 1.5 [0.8–2.3)], the rate of growth slowed between 1993 and 2009 (EAPC; 0.7 [0.6–0.7]). Between 2009 and 2014, ASIR decreased (EAPC; − 0.7 [− 1.1 to − 0.2]), while the curve has been flat between 2014 and 2019 (EAPC; 0.0 [− 0.3 to 0.4]). As with males, recent ASIR trends in females have mostly been flat or negative. The observed increase in Australia between 2017 and 2019 (EAPC: 1.1 [− 2.6 to 4.9]) was statistically non-significant. The greatest decrease has been observed in Austria between 1990 and 2019 (EAPC: − 0.9 [− 1 to − 0.9]).

Recent ASIR trends in WHO regions for females have mostly been positive. The Eastern Mediterranean region has seen the greatest increase between 1999 and 2019 (EAPC: 2.6 [2.5–2.6]). The Americas are the only region to see a fall recently, between 2003 and 2019 (EAPC: − 0.5 [− 0.5 to − 0.4]).

Trends in KC ASMR, 1990–2019

Across the entire study period, there was a rise in ASMR globally for males (+ 19.4%) and a fall for females (− 2.3%). ASMR mainly increased across most WHO regions. The Eastern Mediterranean region had the greatest increase across the study period for males and females, + 87.8% and + 43.0%, respectively. The Americas had the smallest increase for males (+ 8.3%) and was the only region to see a decrease in females (− 16.4%). Recently, the Eastern Mediterranean region observed the greatest increase between 2011 and 2019 (EAPC: 2.3 [2.1–2.4]). The Western Pacific is the only region to observe a decrease recently, between 2011 and 2019 (EAPC: − 0.4 [− 0.7 to − 0.2]).

Among EU 15 + countries, Denmark had the greatest increase in ASMR across the study period for males and females, + 41.7% and 37.7%, respectively. Conversely, Austria had the greatest decrease for males and females, − 33.8% and − 35.8% respectively.

Tables 1 and 2 and, Figs. 1, 2 depict gender-specific trends in KC ASMR across EU 15 + countries and 6 WHO regions.

The Joinpoint analyses for ASMR in males and females are shown in Table 4 and Fig. 4

Table 4 Joinpoint analysis for KC age-standardized mortality rates in EU15 + countries and WHO regions for years 1990–2019 in males (A), females (B) and both sexes (C).
Figure 4
figure 4

Trends in age-standardized mortality rates (ASMR) per 100,000 for KC in EU15 + countries and WHO regions between 1990 and 2019. Open squares indicate males; and filled circles, females.

Global ASMR for males increased between 1990 and 1993 (EAPC: 1.9 [1–2.8]). Between 1993 and 2009, the rate of increase slowed (EAPC: 0.9 [0.8–0.9]). Between 2009 and 2019, there has been a non-significant decrease in ASMR (EAPC: − 0.2 [− 0.3 to 0]).

Amongst EU 15 + countries, recent trends have mostly been negative, except in the USA, in which there has been a recent growth in ASMR between 2014 and 2019 (EAPC 0.7 [0.2–1.1]). Recently, Norway has observed the greatest decrease between 2012 and 2019 (EAPC: − 2.2 [− 2.6 to − 1.8]). WHO regions have mostly seen an increase in ASMR recently.

Global, ASMR for females increased between 1990 and 1994 (EAPC: 0.9 [0.5–1.2]). The trend reversed but was statistically non-significant between 1994 and 1997 (EAPC: − 0.4 [− 1.5 to 0.6]). Again, there was an increase in ASMR between 1997 and 2006 (EAPC: 0.3 [0.1–0.4]). The trend between 2006 and 2019 showed an improvement in mortality (EAPC: − 0.6 [− 0.6 to − 0.5]). The South-East Asian region has seen the largest increase between 2012 and 2019 (EAPC: 1.5 [1.2–1.8]). Europe was the only region with negative growth recently, between 2005 and 2019 (EAPC: − 0.2 [− 0.3 to − 0.2]).

Amongst EU 15 + countries, recent trends have been mixed. The greatest increase but statistically non-significant was observed in the USA between 2017 and 2019 (EAPC: 1 [0–2]). The greatest decrease was observed in Denmark between 1998 and 2019 (EAPC: − 1.6 [− 1.7 to − 1.5]). WHO regions have mostly seen an increase in ASMR recently.

Trends in KC disability-adjusted life-years, 1990–2019

Across the 29-year study period, there was a rise in DALYs globally for males (+ 13.1%) and a fall for females (− 9.4%). Similar trends were seen across all six regions as well. The Eastern Mediterranean region saw the greatest increase for males (+ 76.6%), whereas the Americas saw the smallest rise (+ 2.1%). Apart from the Americas (− 23.5%), all regions saw a rise in DALYs for females, led by the Eastern Mediterranean region (+ 36.3%).

In the EU15 + countries, Denmark saw the greatest rise in DALYs for both males and females, + 38.6% and + 30.2 respectively. Austria saw the greatest decrease in DALYs across the study period for males and females, − 39.5% and − 41.2%, respectively. Figures 1 and 2 depict gender-specific trends in KC DALYs across EU 15 + countries and 6 WHO regions.

Tables 1 and 2 and, Figs. 1 and 2 depict gender-specific trends in KC DALY across EU 15 + countries and 6 WHO regions.

The Joinpoint analyses for DALYs in males and females are shown in Table 5 and Fig. 5

Table 5 Joinpoint analysis for KC age-standardized DALYs in EU15 + countries and WHO regions for years 1990–2019 for both sexes.
Figure 5
figure 5

Trends in disability-adjusted life years (DALYs) per 100,000 for KC in EU15 + countries and WHO regions between 1990 and 2019. Open squares indicate males; and filled circles, females.

Globally, DALYs for males were increasing from 1990 to 1994 (EAPC: 1.8 [1.3–2.2]), followed by a slight decrease from 1994 to 1998 (EAPC: − 0.1 [− 0.9 to 1.4]) and an increase between 1998 to 2005 (EAPC: 1.2 [0.9–1.4]). Since 2005, DALYs have plateaued (EAPC: − 0.2 [− 0.2 to 0.1]).

Amongst EU15 + countries, recent trends have mainly shown reductions, with the greatest decrease amongst males in Ireland from 2009 to 2019 (EAPC: − 1.5 [− 1.8 to 1.1)]. The greatest rise recently was seen in the USA from 2013 to 2019 (EAPC: 0.5 [0.1–0.8]).

Trends have been mixed amongst WHO regions recently. The Eastern Mediterranean region has had the greatest increase recently, between 2000 and 2019 (EAPC; 1.9 [1.9–2.0]). Meanwhile, the Western Pacific region had the greatest decrease recently, between 2011 and 2019 (EAPC; − 0.5 [− 0.8 to − 0.1]). Also, trends across WHO regions have mainly been non-significantly positive recently. The greatest recent rise was seen in South-East Asia between 2012 and 2019 (EAPC: 1.4 [1.1–1.7]). The Americas were the only region with a decrease, albeit not significant (EAPC; − 0.1 [− 0.3 to − 0.1]).

Similar DALYs trends were seen globally for females. Between 1990 and 1994, there was a moderate increase (EAPC: 0.4 [− 0.1 to 0.9)]. Since 1994, there has been a non-significant decrease till 2005. Since 2005, there has been a significant decrease (EAPC: − 0.7 [− 0.7 to − 0.6]). Amongst EU15 + countries, recent trends have been mostly negative for males. The most recent significant increase was observed in Australia between 2016 and 2019 (EAPC: 0.9 [0.3–1.6]). The greatest decrease was observed in Belgium between 1999 and 2019 (EAPC: − 1.3 [− 1.5 to − 1.1]).

Trends in KC MIR, 1990–2019

Across the study period, there was a decrease in MIR globally for both males (− 13.7%) and females (− 13.9%). All EU 15 + countries saw a decrease in MIR across the study period. Portugal saw the greatest decrease in males with a − 29.0% fall, while Ireland saw the greatest decrease in females with a − 26.6% fall. Sweden saw the smallest decrease in males and females with only a − 11.7% and − 8.5% fall, respectively. These trends were reflected across WHO regions, where all regions saw decreases in MIR across the study period. The Western Pacific region saw the greatest decrease in MIR in males with a − 27.3% reduction, while the Western Pacific and Eastern Mediterranean region were equivalent for females with − 27.9% reductions. The Americas saw the smallest decrease in MIR for both males and females over the study period, − 6.9% and − 10.2%, respectively.

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