The rising burden of male genitourinary cancers in middle- and high-income countries.

Introduction: Male genitourinary cancers (prostate, bladder, kidney, and testicular) represent a major cancer burden in middle- and high-income countries (MHIC). We aimed to characterize their distribution and trends across 174 countries using the 2023 Global Burden of Disease (GBD) database. Methods: This study presented the incidence, mortality, disability-adjusted life years (DALYs), and age-standardized rates for four male genitourinary cancers by age and location from 1990 to 2023. Average annual percent changes (AAPCs) and Bayesian Age-Period-Cohort (BAPC) models were utilized to quantify temporal dynamics and project trends to 2050. Results: In 2023, an estimated 2.16 million new cases and 0.73 million deaths were attributed to male genitourinary cancers in MHIC. From 1990 to 2023, age-standardized incidence rates (ASIRs) increased for PCa, KCa, and TCa across all income groups. However, age-standardized mortality rates (ASMRs) exhibited divergent trends: declining significantly in high-income countries (HC) while remaining stable or increasing in lower-middle-income countries (LMC). Smoking remained the predominant risk factor, though metabolic factors (high BMI, hyperglycemia) demonstrated increasingly prominent population-attributable fractions in wealthier nations. Projections to 2050 suggest a growing burden in LMC and upper-middle-income countries (UMC). Conclusion: The marked increase in ASIRs in wealthier nations partially reflects superior diagnostic capacity (e.g., PSA screening) rather than exclusively a true increase in disease burden. The divergence between rising incidence and persistently high mortality in LMC highlights the urgent need for tailored, resource-stratified public health strategies.