Rising incidence and clinical impact of kidney cancer in China and worldwide: a call for targeted prevention, early diagnosis, and equitable treatment.

Background: Kidney cancer is an increasing global public health challenge, with its incidence rising due to aging populations, lifestyle transitions, and advances in diagnostic technologies. However, this growth is unevenly distributed across regions, driven by disparities in healthcare access, socioeconomic conditions, and lifestyle factors. In China, kidney cancer incidence and mortality have escalated significantly, fueled by an aging population, urbanization, and higher prevalence of risk factors such as smoking and hypertension. Rural areas face disproportionately late-stage diagnoses due to healthcare inequities. Globally, notable gender differences persist, as men consistently exhibit higher rates of both incidence and mortality in comparison to women. This study aimed to analyze kidney cancer trends and risk factor contributions in China and globally from 1990 to 2021 to inform targeted public health strategies. Methods: This study utilized data from the Global Burden of Disease (GBD) 2021 database to explore trends in kidney cancer between 1990 and 2021. Critical indicators, including age-standardized rates (ASRs) for incidence, prevalence, mortality, and disability-adjusted life years (DALYs), were examined using Joinpoint regression to uncover temporal patterns and demographic distinctions. Data stratification by age, gender, and region was performed, with advanced modeling approaches such as Disease Modeling-Meta-Regression (DisMod-MR) and Cause of Death Ensemble model (CODEm) employed to standardize outcomes and mitigate reporting inconsistencies. Results: From 1990 to 2021, kidney cancer in China exhibited substantial increases in incidence, prevalence, and mortality rates. The age-standardized incidence rate (ASIR) grew from 1.794 to 3.319 per 100,000, while the prevalence rate rose from 7.191 to 17.754 per 100,000. Mortality rates experienced a moderate rise, with the age-standardized mortality rate (ASMR) increasing from 1.14 to 1.246 per 100,000. Although DALYs rose significantly, the age-standardized DALY rate (ASDR) displayed a marginal decline, dropping from 35.838 to 34.176 per 100,000. In China, contributions of smoking and high body mass index (BMI) to kidney cancer mortality and DALYs increased, while occupational exposure to trichloroethylene remained stable; globally, high BMI rose to become the leading risk factor, surpassing smoking, which declined. On a global scale, incidence and prevalence of kidney cancer steadily climbed, while mortality and DALY rates exhibited slight decreases, attributable to improvements in early diagnosis and treatment strategies. Gender disparities persisted, with men consistently showing higher rates across all metrics compared to women. Conclusions: Over 30 years, kidney cancer burden has risen sharply with regional, demographic, and gender disparities. China needs to reduce urban-rural gaps and improve early diagnosis. Globally, limited care access persists in low-income areas. Rising high BMI calls for metabolic interventions. Public health must ensure equitable care and targeted prevention to combat this burden.