Global, regional, and national burden of early-onset kidney cancer in adolescents and young adults aged 15-39 years from 1990 to 2021: a systematic analysis for the Global Burden of Disease Study 2021
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Background Kidney cancer occurring in adolescents and young adults is increasingly recognized as a significant global health concern. However, its long-term epidemiological patterns remain underexplored. Aim To evaluate global, regional, and national burdens and trends of early-onset kidney cancer (EOKC) from 1990 to 2021 to support the development of targeted prevention and intervention strategies. Methods Data were obtained from the Global Burden of Disease (GBD) 2021 database. Analyses focused on individuals aged 15–39 years, assessing global and regional incidence, mortality, and disability-adjusted life years (DALYs) using age-standardized rates (ASRs) to adjust for demographic variability. Temporal trends were assessed using estimated annual percentage change (EAPC) and average annual percentage change (AAPC). The Bayesian age-period-cohort (BAPC) model was employed for forecasting. Results Globally, 17,622 new EOKC cases were reported in 2021, with the highest incidence in Southern Latin America and the largest case numbers in East Asia. From 1990 to 2021, global EOKC incidence increased by 31.6%, driven primarily by high and middle SDI regions. DALYs showed an inverted U-shaped relationship with SDI, peaking in moderately developed settings. High body mass index was the leading attributable risk factor, followed by tobacco use and occupational exposures. BAPC projections suggest continued increases in incidence but declining mortality and DALYs by 2035. Conclusions EOKC poses a growing and uneven global burden, particularly in rapidly developing regions. Targeted prevention strategies addressing modifiable risk factors and improved resource allocation are essential to mitigate future impact.