Analysis of the disease burden of bladder cancer attributed to smoking and high fasting blood glucose in five East Asian countries from 1990 to 2021

ZHANG Jie; LU Mengxin; WEN Jun; LUAN Hanghang; HE Shaohua; ZI Hao; QIN Lihong; LUO Lisha

doi:10.12173/j.issn.1004-5511.202409132

Abstract：Objective To study the disease burden of bladder cancer attributed to smoking and high fasting blood glucose(HFBG)among five East Asian countries from 1990 to 2021,providing a scientific basis for formulating bladder cancer prevention and control policies.Methods Data were sourced from the 2021 Global Burden of Disease study.The Joinpoint regression model was used to assess the temporal trends,and the age-period-cohort(APC)model was employed to evaluate the independent effects of age,period,and birth cohort on attributable burden.Results In 2021,China had the highest burden of bladder cancer attributed to smoking,while Japan had the highest burden attributed to HFBG.From 1990 to 2021,the smoking-attributed burden in the five East Asian countries showed declining trends(AAPC＜0),with the largest decrease in South Korea(mortality rate-AAPC=-1.87％,DALY rate-AAPC=-2.29％).HFBG-attributed burden in China showed a declining trend(AAPC＜0),whereas it exhibited increasing trends in North Korea(AAPC＞0).APC results indicated that the age effects of both smoking and HFBG showed upward trends,peaking in the age group of 80 and above;the birth cohort effects for smoking-attributed rates in the five East Asian countries showed declining trends,while HFBG-attributed rates showed declining trends in all countries except North Korea.Conclusion Smoking and HFBG are significant independent risk factors for bladder cancer in the five East Asian countries,especially in China and Japan.Age is the main reason for the rising bladder cancer attributed burden,with the elderly being a high-risk population.Future prevention and control measures should target high-risk groups,improve residents'awareness of smoking-related bladder cancer,and effectively reduce the incidence of diabetes to decrease the disease burden of bladder cancer.