Epidemiological Trends of Kidney Cancer Along with Attributable Risk Factors in China from 1990 to 2019 and Its Projections Until 2030: An Analysis of the Global Burden of Disease Study 2019

Figures & data

Table 1 The Number of Incident Cases and the Age‐standardized Incidence Rates of Kidney Cancer in China in 1990 and 2019 and the Estimated Annual Percentage Changes from 1990 to 2019

Characteristics	1990		2019		1990–2019
	Incident Cases No.×10^3 (95% UI)	ASIR per 100,000 No. (95% UI)	Incident Cases No.×10^3 (95% UI)	ASIR per 100,000 No. (95% UI)	EAPC in ASIR No. (95% CI)
Overall	11.07 (9.79, 12.59)	1.16 (1.02, 1.31)	59.83 (49.51, 71.24)	3.21 (2.7, 3.79)	4.46 (3.95, 4.98)
Sex
Male	6.16 (5.06, 7.48)	1.32 (1.09, 1.6)	42.55 (33.14, 53.17)	4.63 (3.67, 5.73)	5.46 (4.88, 6.04)
Female	4.92 (4.24, 5.68)	1.02 (0.88, 1.17)	17.27 (13.84, 21.3)	1.92 (1.58, 2.32)	2.80 (2.38, 3.23)
Age^a
Under 5	1.86 (1.52, 2.22)	1.61 (1.32, 1.93)	1.55 (1.26, 1.86)	1.90 (1.54, 2.28)	1.27 (0.80, 1.74)
5–9	0.36 (0.30, 0.42)	0.34 (0.29, 0.40)	0.45 (0.38, 0.53)	0.62 (0.53, 0.73)	2.73 (2.30, 3.16)
10–14	0.15 (0.13, 0.17)	0.14 (0.12, 0.17)	0.23 (0.2, 0.26)	0.32 (0.28, 0.37)	3.74 (3.25, 4.24)
15–19	0.21 (0.18, 0.25)	0.17 (0.14, 0.20)	0.29 (0.24, 0.35)	0.38 (0.32, 0.46)	3.92 (3.26, 4.59)
20–24	0.26 (0.21, 0.31)	0.19 (0.16, 0.23)	0.57 (0.47, 0.69)	0.69 (0.57, 0.85)	5.70 (4.97, 6.43)
25–29	0.27 (0.23, 0.32)	0.25 (0.2, 0.29)	1.07 (0.9, 1.28)	0.97 (0.81, 1.16)	6.32 (5.69, 6.96)
30–34	0.32 (0.27, 0.38)	0.36 (0.3, 0.43)	2.03 (1.68, 2.42)	1.57 (1.30, 1.88)	6.48 (5.86, 7.10)
35–39	0.57 (0.47, 0.67)	0.62 (0.52, 0.73)	2.62 (2.14, 3.18)	2.60 (2.12, 3.15)	6.00 (5.39, 6.62)
40–44	0.62 (0.52, 0.74)	0.92 (0.77, 1.10)	3.86 (3.09, 4.8)	3.80 (3.04, 4.72)	6.01 (5.40, 6.63)
45–49	0.62 (0.51, 0.74)	1.19 (0.99, 1.43)	5.07 (3.98, 6.33)	4.18 (3.28, 5.22)	5.76 (5.12, 6.41)
50–54	0.85 (0.71, 1.02)	1.78 (1.49, 2.14)	6.87 (5.45, 8.59)	5.49 (4.36, 6.86)	5.03 (4.44, 5.62)
55–59	1.09 (0.92, 1.32)	2.52 (2.11, 3.04)	6.65 (5.29, 8.32)	7.02 (5.58, 8.78)	4.51 (3.97, 5.05)
60–64	1.08 (0.91, 1.27)	3.04 (2.58, 3.59)	6.41 (5.28, 7.73)	8.16 (6.73, 9.84)	4.16 (3.72, 4.61)
65–69	0.98 (0.84, 1.13)	3.58 (3.08, 4.11)	6.87 (5.68, 8.22)	9.76 (8.08, 11.67)	4.04 (3.61, 4.46)
70–74	0.82 (0.71, 0.94)	4.34 (3.77, 4.96)	5.93 (4.93, 7.05)	12.38 (10.31, 14.73)	4.19 (3.59, 4.79)
75–79	0.57 (0.50, 0.65)	5.03 (4.37, 5.73)	4.57 (3.82, 5.42)	15.31 (12.81, 18.16)	4.98 (4.36, 5.60)
80–84	0.3 (0.26, 0.34)	5.37 (4.63, 6.09)	2.99 (2.51, 3.5)	15.71 (13.16, 18.35)	4.92 (4.29, 5.56)
85–89	0.12 (0.1, 0.14)	6.44 (5.4, 7.37)	1.51 (1.28, 1.74)	17.72 (15.08, 20.44)	4.56 (4.09, 5.03)
90–94	0.02 (0.02, 0.02)	5.08 (4.17, 5.9)	0.27 (0.22, 0.32)	12.01 (9.81, 14.1)	3.60 (3.26, 3.93)
95+	0.002 (0.002, 0.003)	3.58 (2.93, 4.17)	0.03 (0.02, 0.04)	7.35 (5.51, 9.09)	3.11 (2.74, 3.47)

Abbreviations: ASIR, age‐standardized incidence rate; CI, confidence interval; EAPC, estimated annual percentage change; UI, uncertainty interval; ^a, crude incidence rate in each age group.

Table 2 The Number of Deaths and the Age‐standardized Mortality Rates of Kidney Cancer in China in 1990 and 2019 and the Estimated Annual Percentage Changes from 1990 to 2019

Characteristics	1990		2019		1990–2019
	Deaths Cases No.×10^3 (95% UI)	ASMR per 100,000 No. (95% UI)	Deaths Cases No.×10^3 (95% UI)	ASMR per 100,000 No. (95% UI)	EAPC in ASMR No. (95% CI)
Overall	5.88 (5.14, 6.69)	0.7 (0.61, 0.79)	23.95 (19.77, 28.48)	1.27 (1.05, 1.49)	2.79 (2.33, 3.26)
Sex
Male	3.33 (2.73, 4.07)	0.85 (0.7, 1.01)	16.88 (13.18, 20.84)	1.96 (1.55, 2.38)	3.82 (3.3, 4.34)
Female	2.55 (2.19, 2.94)	0.59 (0.5, 0.67)	7.07 (5.68, 8.62)	0.72 (0.59, 0.87)	1.17 (0.8, 1.53)
Age^a
Under 5	0.57 (0.46, 0.67)	0.49 (0.4, 0.58)	0.22 (0.18, 0.26)	0.26 (0.22, 0.32)	−1.72 (−2.11, −1.33)
5–9	0.1 (0.08, 0.12)	0.1 (0.08, 0.11)	0.06 (0.05, 0.08)	0.09 (0.07, 0.1)	0.11 (−0.25, 0.47)
10–14	0.05 (0.04, 0.05)	0.04 (0.04, 0.05)	0.03 (0.03, 0.04)	0.05 (0.04, 0.06)	1.05 (0.64, 1.46)
15–19	0.05 (0.04, 0.06)	0.04 (0.03, 0.05)	0.04 (0.03, 0.05)	0.05 (0.04, 0.06)	1.48 (0.93, 2.03)
20–24	0.07 (0.06, 0.09)	0.05 (0.04, 0.06)	0.08 (0.06, 0.1)	0.1 (0.08, 0.12)	2.93 (2.34, 3.51)
25–29	0.08 (0.07, 0.1)	0.07 (0.06, 0.09)	0.16 (0.13, 0.19)	0.14 (0.12, 0.17)	3.43 (2.93, 3.94)
30–34	0.1 (0.09, 0.12)	0.12 (0.1, 0.14)	0.31 (0.26, 0.38)	0.24 (0.2, 0.29)	3.53 (3.00, 4.06)
35–39	0.2 (0.16, 0.23)	0.21 (0.18, 0.25)	0.43 (0.35, 0.53)	0.43 (0.35, 0.52)	3.14 (2.58, 3.71)
40–44	0.23 (0.19, 0.28)	0.34 (0.28, 0.41)	0.68 (0.54, 0.84)	0.67 (0.54, 0.83)	3.20 (2.66, 3.75)
45–49	0.28 (0.23, 0.34)	0.54 (0.44, 0.65)	1.22 (0.95, 1.51)	1 (0.79, 1.24)	3.30 (2.75, 3.86)
50–54	0.45 (0.37, 0.54)	0.93 (0.78, 1.12)	2.07 (1.62, 2.59)	1.65 (1.3, 2.07)	2.83 (2.32, 3.33)
55–59	0.65 (0.54, 0.78)	1.49 (1.23, 1.79)	2.41 (1.88, 3)	2.54 (1.98, 3.16)	2.55 (2.07, 3.03)
60–64	0.69 (0.58, 0.82)	1.95 (1.63, 2.32)	2.58 (2.1, 3.17)	3.29 (2.67, 4.03)	2.33 (1.92, 2.74)
65–69	0.7 (0.6, 0.81)	2.56 (2.21, 2.97)	3.19 (2.63, 3.8)	4.53 (3.74, 5.4)	2.37 (1.96, 2.78)
70–74	0.65 (0.56, 0.74)	3.42 (2.95, 3.91)	3.13 (2.62, 3.69)	6.53 (5.48, 7.71)	2.63 (2.06, 3.20)
75–79	0.52 (0.46, 0.59)	4.58 (4, 5.2)	2.94 (2.47, 3.47)	9.86 (8.28, 11.63)	3.59 (3.02, 4.17)
80–84	0.32 (0.27, 0.36)	5.68 (4.87, 6.42)	2.4 (2.01, 2.81)	12.57 (10.55, 14.74)	3.81 (3.21, 4.41)
85–89	0.15 (0.13, 0.18)	8.03 (6.77, 9.13)	1.6 (1.37, 1.85)	18.87 (16.16, 21.74)	3.94 (3.49, 4.38)
90–94	0.03 (0.02, 0.03)	7.37 (6.1, 8.44)	0.35 (0.29, 0.41)	15.55 (12.75, 18.35)	3.15 (2.83, 3.47)
95+	0.004 (0.003, 0.004)	6.21 (4.98, 7.22)	0.05 (0.04, 0.07)	11.98 (9.16, 14.75)	2.8 (2.45, 3.15)

Abbreviations: ASMR, age‐standardized mortality rate; CI, confidence interval; EAPC, estimated annual percentage change; UI, uncertainty interval; ^a, crude mortality rate in each age group.

Table 3 The Number of DALYs and the Age‐standardized DALYs Rates of Kidney Cancer in China in 1990 and 2019 and the Estimated Annual Percentage Changes from 1990 to 2019

Characteristics	1990		2019		1990–2019
	DALYs No.×10^3 (95% UI)	Age-Standardized DALYs Rate per 100,000 No. (95% UI)	DALYs No.×10^3 (95% UI)	Age-Standardized DALYs Rate per 100,000 No. (95% UI)	EAPC in Age-Standardized DALYs Rates No. (95% CI)
Overall	215.76 (190.36, 243.56)	21.59 (19.04, 24.4)	642.8 (533.66, 763.98)	34.28 (28.95, 40.16)	2.28 (1.83, 2.73)
Sex
Male	121.56 (100.81, 146.97)	24.44 (20.39, 29.5)	462.87 (363.08, 571.56)	49.65 (39.57, 60.57)	3.33 (2.82, 3.85)
Female	94.21 (81.14, 107.59)	19.04 (16.49, 21.63)	179.93 (147.91, 216.68)	20.07 (16.75, 23.75)	0.55 (0.19, 0.9)
Age^a
Under 5	50.18 (40.99, 59.23)	43.49 (35.52, 51.33)	19.47 (15.95, 23.36)	23.89 (19.57, 28.66)	−1.63 (−2.02, −1.24)
5–9	8.35 (7.00, 9.73)	7.97 (6.68, 9.29)	5.45 (4.65, 6.51)	7.51 (6.40, 8.96)	0.19 (−0.17, 0.56)
10–14	3.53 (3.01, 4.11)	3.43 (2.93, 4.00)	2.73 (2.36, 3.19)	3.87 (3.34, 4.52)	1.14 (0.73, 1.55)
15–19	3.89 (3.19, 4.59)	3.06 (2.51, 3.62)	2.91 (2.41, 3.50)	3.87 (3.21, 4.66)	1.58 (1.03, 2.13)
20–24	4.83 (3.93, 5.83)	3.65 (2.97, 4.41)	5.60 (4.55, 6.77)	6.84 (5.55, 8.27)	3.04 (2.45, 3.63)
25–29	5.03 (4.17, 6.03)	4.56 (3.78, 5.47)	10.22 (8.56, 12.09)	9.23 (7.73, 10.92)	3.56 (3.05, 4.07)
30–34	6.03 (5.01, 7.09)	6.81 (5.67, 8.01)	18.81 (15.69, 22.69)	14.57 (12.15, 17.58)	3.65 (3.12, 4.19)
35–39	10.33 (8.59, 12.21)	11.29 (9.39, 13.35)	23.6 (19.27, 28.69)	23.39 (19.1, 28.44)	3.27 (2.71, 3.83)
40–44	10.93 (9.13, 13.18)	16.25 (13.58, 19.6)	33.92 (27.16, 41.32)	33.37 (26.72, 40.65)	3.33 (2.78, 3.87)
45–49	11.91 (9.80, 14.37)	23.03 (18.94, 27.79)	53.45 (42.05, 65.79)	44.04 (34.65, 54.21)	3.41 (2.85, 3.97)
50–54	16.92 (14.07, 20.15)	35.39 (29.42, 42.16)	80.04 (63.03, 99.36)	63.98 (50.39, 79.42)	2.91 (2.41, 3.42)
55–59	21.38 (17.79, 25.72)	49.20 (40.93, 59.18)	81.08 (64.54, 100.05)	85.50 (68.06, 105.50)	2.62 (2.13, 3.10)
60–64	19.65 (16.39, 23.33)	55.49 (46.28, 65.87)	74.70 (60.92, 91.15)	95.09 (77.56, 116.03)	2.40 (1.98, 2.81)
65–69	16.69 (14.36, 19.32)	60.98 (52.49, 70.60)	77.06 (64.05, 91.61)	109.49 (91, 130.16)	2.43 (2.02, 2.84)
70–74	12.59 (10.90, 14.34)	66.76 (57.78, 76.04)	61.90 (52.08, 72.46)	129.35 (108.83, 151.42)	2.69 (2.12, 3.26)
75–79	8.08 (7.05, 9.15)	70.83 (61.82, 80.23)	45.92 (38.79, 54.14)	153.84 (129.98, 181.41)	3.63 (3.06, 4.2)
80–84	3.81 (3.27, 4.31)	67.62 (58.02, 76.47)	28.60 (24.09, 33.49)	149.99 (126.32, 175.62)	3.82 (3.22, 4.42)
85–89	1.40 (1.18, 1.60)	73.24 (61.70, 83.30)	14.58 (12.52, 16.79)	171.41 (147.25, 197.43)	3.92 (3.48, 4.37)
90–94	0.20 (0.16, 0.22)	52.50 (43.36, 60.07)	2.47 (2.04, 2.91)	110.07 (90.75, 129.67)	3.14 (2.82, 3.46)
95+	0.02 (0.02, 0.02)	34.24 (27.55, 39.83)	0.29 (0.22, 0.35)	64.11 (49.18, 78.73)	2.69 (2.33, 3.04)

Abbreviations: CI, confidence interval; DALYs, disability-adjusted life-years; EAPC, estimated annual percentage change; UI, uncertainty interval; ^a, crude DALYs rate in each age group.

Figure 1 Disease burden of kidney cancer in 2019 in China. Numbers and rates of incidence (A), mortality (B), and DALYs (C) of kidney cancer by age and sex in 2019 in China. Shading represents the upper and lower limits of the 95% uncertainty intervals (95% UIs). DALYs, disability-adjusted life-years.

Figure 2 Temporal trends in kidney cancer burden from 1990 to 2019 in China. The number of incident cases (A), incidence rate (B) of kidney cancer by age and sex, from 1990 to 2019 in China; EAPC of incidence rate (C) of kidney cancer by age and sex in 2019 in China. EAPC, estimated annual percentage change.

Figure 3 The province-level burden of kidney cancer in 2017 in China. Age-standardized DALY rate per 100,000 population by the province of China in 2017 (A) and age-standardized DALY rates for kidney cancer and SDI by province, for 2017 (B). DALY, disability-adjusted life-years, ASDR, age-standardized DALY rate, SDI, social-demographic index.

Figure 4 Risk factor analysis for kidney cancer in China. Proportions of DALYs of kidney cancer attributable to risk factors by sex from 1990 to 2019 in China (A); and proportions of DALYs attributable to risk factors by age and sex in 2019 in China (B). DALYs, disability-adjusted life-years.

Figure 5 Predictions of kidney cancer incidence and death rates in China until 2030. Temporal trends and projected age-standardized incidence rate and age-standardized death rate by sex, from 1990 to 2030 in China (A and B for male, C and D for female); Trends in observed (dashed lines) and projected (solid lines) kidney cancer in the number of incidence cases (E) and deaths (F) from 1990 to 2030. Shading represents a 2% decreasing and increasing interval based on the 2019 rate.