BACKGROUND-AIM:
Tobacco smoking is causally linked to several genitourinary cancers, yet these cancers are often not widely recognized as tobacco-related. We aimed to describe the global epidemiology and temporal trends of tobacco use and genitourinary cancers to identify high-risk populations that may benefit from targeted interventions.

METHODS:
We conducted a descriptive epidemiological analysis using data from the WHO Global Cancer Observatory (GLOBOCAN), country-specific WHO tobacco use prevalence reports, and the Global Burden of Disease (GBD) study. For each WHO Member State, we extracted the number of incident cases and deaths; age-standardized incidence rates; age-standardized mortality rates; and disability-adjusted life years (DALYs); for genitourinary cancers, including prostate, bladder, kidney, penile, and testicular cancers. We also obtained annual estimates of tobacco use prevalence. Temporal trends in cancer incidence were evaluated using estimated annual percentage changes in age-standardized rates. All analyses were stratified by WHO region to compare geographic patterns and identify populations at highest risk.

RESULTS:
In 2022, more than 2.6 million individuals worldwide were diagnosed with genitourinary cancers, and approximately 800000 died from these diseases. Over the past three decades, global age-standardized incidence rates of kidney, prostate, and testicular cancers have increased (estimated annual percentage change: +0.53%, +0.20%, and +1.43%, respectively), whereas bladder cancer incidence has declined. During the same period, the number of deaths and DALYs attributable to tobacco smoking increased for bladder, kidney, and prostate cancers by 43%, 67%, and 31%, respectively, and DALYs increased by 31%, 52%, and 29%. The burden of genitourinary cancers is highest in Europe, where incidence rates for prostate, bladder, and kidney cancers are among the highest globally. This pattern reflects, in part, the region’s persistently high prevalence of tobacco use. An estimated 173 million adults (24.6% of the adult population) currently use tobacco in Europe. Between 2010 and 2025, tobacco use in Europe has decreased by only 17%, the second-smallest reduction among WHO regions. Europe is also the only region that has failed to achieve the Global Action Plan target of a 30% relative reduction in tobacco use among women, with an estimated reduction of just 9% by 2025. Since 2020, declines in tobacco use have slowed markedly, particularly among women.

CONCLUSIONS:
Genitourinary cancers continue to impose a substantial global burden, with the highest incidence observed in Europe, mirroring the region’s high tobacco use. Europe remains one of the slowest-improving WHO regions, particularly among women, where reductions in tobacco use have nearly plateaued. These findings highlight an urgent need for strengthened, region-specific tobacco control strategies to address the growing burden of genitourinary cancers, particularly in Europe.