Global, Regional and National Burden of Bladder Cancer, 1990 to 2016: Results from the GBD Study 2016.

PURPOSE: Bladder cancer is among the leading causes of cancer death worldwide. Data on the bladder cancer burden are valuable for policy-making. We aimed to estimate the burden of bladder cancer by country, age group, gender and sociodemographic status between 1990 and 2016. MATERIALS AND METHODS: Data from vital registration systems and cancer registries were the input to estimate the bladder cancer burden. Mortality was estimated in an ensemble model approach, incidence was estimated by dividing mortality by the mortality-to-incidence ratio and prevalence was estimated using the mortality-to-incidence ratio as a surrogate for survival. We modeled the years lived with disability using disability weights of bladder cancer sequelae. Years of life lost were calculated by multiplying the number of deaths by age by the standard life expectancy at that age. Disability adjusted life-years were calculated by summing the years lived with disability and the years of life lost. Moreover, we also estimated the burden attributable to bladder cancer risk factors, smoking and high fasting plasma glucose using the comparative risk assessment framework of the Global Burden of Disease study. RESULTS: In 2016 there were 437,442 incident cases (95% UI 426,709-447,912) of bladder cancer with an age standardized incidence rate of 6.69/100,000 (95% UI 6.52-6.85). Bladder cancer led to 186,199 deaths (95% UI 180,453-191,686) in 2016 with an age standardized rate of 2.94/100,000 (95% UI 2.85-3.03). Bladder cancer was responsible for 3,315,186 disability adjusted life-years (95% UI 3,193,248-3,425,530) in 2016 with an age standardized rate of 49.45/100,000 (95% UI 47.68-51.11). Of bladder cancer deaths 26.84% (95% UI 19.78-33.91) and 7.29% (95% UI 1.49-16.19) were due to smoking and high fasting glucose, respectively, in 2016. CONCLUSIONS: Although the number of bladder cancer incident cases is growing globally, the age standardized incidence and number of deaths are decreasing, as mirrored by a decreasing smoking contribution.

National and subnational mortality of urological cancers in Iran, 1990-2015.

PURPOSE: To study trends of urological cancers mortalities in Iran between 1990 and 2015 as a part of a larger project named national and subnational burden of diseases, injuries, and risk factors. METHODS: The primary dataset of this project comprises data of national death registration system. Cause-specific mortality fraction for each age, sex, province, and year group was calculated using a two-stage mixed effects and spatiotemporal models, and then these fractions were applied to all-cause mortality rates, obtained from a parallel study to estimate mortality rates attributable to each cause. RESULTS: In 2015, urological cancers constituted 8% of cancer-related deaths in Iran, and number of deaths due to prostate, bladder, testicular, and kidney and other urinary organs cancers were estimated as 2,128 (1,565-2,891), 297 (230-385), 301 (144-639), and 195 (143-267), respectively. Our estimates show that age-standardized death rates (ASDRs) of these cancers reached 6.8 (5-9.23), 0.47 (0.37-0.61), 0.96 (0.46-2.04), and 0.24 (0.18-0.33) deaths per 100,000 individuals in 2015, a reduction in the three latter cancers, from 4.09 (2.92-5.76), 13.04 (10.04-16.95), 1.23 (0.46-3.34), and 1.76 (1.28-2.42) deaths per 100,000 individuals in 1990, respectively. CONCLUSIONS: In conclusion, despite disparities among different provinces, overall mortality rate of urological cancers decreased significantly since 1990s in Iran.