Incidence and mortality trends in genitourinary cancer in Southeast Asia from 1990-2021.
Authors: Columbres Rod Carlo Agram , Selokar Aryan , Sha Sybil , Ranganathan Sruthi , Wu James Fan , Feliciano Erin , Mahal Brandon A. , Nguyen Paul L. , Dee Edward Christopher Christopher 
Published: February 2025

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Background:
The global burden of genitourinary (GU) cancers has been increasing due to aging populations and advancements in technology. However, little is known about the burden of GU cancers specific to Southeast Asia (SEA), a diverse region of over 690 million people. This study presents the most updated trends in incidence and mortality of the bladder, kidney, prostate, and testicle cancers across SEA from 1990 to 2021.
Methods:
Data were extracted from the Global Burden of Disease (GBD) 2021 database to analyze the incidence, deaths, and age-standardized rates (ASR) by sex and age for four major GU cancers in Brunei, Cambodia, Timor-Leste, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand, and Vietnam from 1990 to 2021.
Results:
From 1990 to 2021, SEA countries had an increase in overall GU cancer incidence (16,947 to 74,556) and mortality (20,500 to 61,113) for all ages. Bladder cancer showed the greatest rise in incidence (4,334 to 15,783) and deaths (8,586 to 24,375) for both sexes, while prostate cancer had the largest absolute increase in male incidence (8,431 to 42,362) and mortality (6,850 to 23,764). For bladder cancer, Thailand had the highest ASIR in 2021 for males, and Brunei for females. From 1990 to 2021, ASIR rose in Vietnam but decreased in Singapore for males, while rising in Malaysia for females. The highest ASMR in 2021 was in Malaysia for males and Brunei for females. From 1990 to 2021, ASMR declined in Singapore for males and in Singapore, Thailand, and Myanmar for females. For kidney cancer, Brunei had the highest ASIR and ASMR in 2021 for both sexes. From 1990 to 2021, ASIR rose in all countries except Timor-Leste, Myanmar, and Laos for males, and increased in Malaysia, Philippines, Indonesia, Singapore, Thailand, and Vietnam for females. ASMR rose in Indonesia, Thailand, Vietnam, and Philippines in males, and in Indonesia and Vietnam for females. For prostate cancer, Singapore had the highest ASIR in 2021, with ASIR increasing in all countries except Laos from 1990 to 2021. ASMR was highest in the Philippines in 2021. From 1990 to 2021, ASMR rose in Cambodia and Indonesia. For testicular cancer, Singapore had the highest ASIR in 2021. From 1990 to 2021, ASIR rose in all countries but Brunei and Philippines. ASMR was highest in Malaysia in 2021 and remained stable throughout the region from 1990 to 2021.
Conclusions:
The burden of GU cancers in SEA has significantly increased from 1990 to 2021, with bladder and prostate cancers showing the largest rises in incidence and deaths. Brunei consistently exhibited the highest ASIR and ASMR for kidney and bladder cancers. For prostate and testicular cancer, Singapore had the highest ASIR while ASMR was highest in the Philippines for prostate and Malaysia for testicular cancer. These findings highlight the urgent need for enhanced resource allocation and targeted interventions to address the growing GU cancer burden and disparities in the region.