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中华腔镜泌尿外科杂志(电子版) ›› 2026, Vol. 20 ›› Issue (01) : 34 -43. doi: 10.3877/cma.j.issn.1674-3253.2026.01.005

临床研究

1990~2021年全球膀胱癌疾病负担趋势分析及2050年预测：一项基于GBD 2021的系统分析
孙晓宇1, 方程2, 李晓阳3, 吴尚融1, 徐熙童1, 张廷继1, 李健1,†()   
  1. 1300121　天津市人民医院，南开大学第一附属医院泌尿外科
    2300211　天津医科大学第二医院泌尿外科
    3100044　北京大学人民医院泌尿外科
  • 收稿日期:2025-09-07 出版日期:2026-02-01
  • 通信作者: 李健
  • 基金资助:
    天津市人民医院科研项目(2018YJZD004)

Analysis of global burden of bladder cancer from 1990 to 2021 and prediction for 2050: a systematic analysis based on the Global Burden of Disease Study 2021

Xiaoyu Sun1, Cheng Fang2, Xiaoyang Li3, Shangrong Wu1, Xitong Xu1, Tingji Zhang1, Jian Li1,†()   

  1. 1Department of Urology, Tianjin People's Hospital, the First Affiliated Hospital of Nankai University, Tianjin 300121, China
    2Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China
    3Department of Urology, Peking University People's Hospital, Beijing 100044, China
  • Received:2025-09-07 Published:2026-02-01
  • Corresponding author: Jian Li
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引用本文：

孙晓宇, 方程, 李晓阳, 吴尚融, 徐熙童, 张廷继, 李健. 1990~2021年全球膀胱癌疾病负担趋势分析及2050年预测：一项基于GBD 2021的系统分析[J/OL]. 中华腔镜泌尿外科杂志(电子版), 2026, 20(01): 34-43.

Xiaoyu Sun, Cheng Fang, Xiaoyang Li, Shangrong Wu, Xitong Xu, Tingji Zhang, Jian Li. Analysis of global burden of bladder cancer from 1990 to 2021 and prediction for 2050: a systematic analysis based on the Global Burden of Disease Study 2021[J/OL]. Chinese Journal of Endourology(Electronic Edition), 2026, 20(01): 34-43.

目的

膀胱癌是全球范围内的重要公共卫生问题，也是导致癌症相关死亡的主要原因之一。本研究旨在分析1990年至2021年全球、地区及国家层面的膀胱癌流行病学趋势，并对2050年前的变化趋势进行预测。

方法

本研究基于全球疾病负担（GBD）2021年研究数据，分析1990年至2021年间膀胱癌的发病、死亡和伤残调整寿命年（DALYs）等指标，预测至2050年的趋势变化。并探讨膀胱癌的主要危险因素和不同社会人口指数（SDI）区域的疾病负担差异。

结果

2021年全球共有540 309.73（95%UI：494 720.89~582 579.44）例膀胱癌新发病例，221 888.32（95%UI：200 567.17~242 326.46）例患者死亡，导致4 397 066.63（95%UI：4 063 656.74~4 813 655.42）DALYs。发病率最高的国家是黎巴嫩共和国，死亡率最高的则为马里。膀胱癌的发病和死亡主要集中在高和中高SDI地区。过去三十年膀胱癌的绝对发病和死亡人数持续上升，经年龄标准化后的发病率（ASIR）、死亡率（ASMR）和DALYs率（ASDR）整体呈下降趋势。模型预测显示，从2021年到2050年，全球的ASIR、ASMR和ASDR将继续下降。吸烟和空腹血糖升高被确认为主要的危险因素。

结论

膀胱癌的负担在全球范围内呈现区域和国家层面的显著差异，强调制定有针对性的预防策略的重要性。控制吸烟率和管理血糖水平，有助于降低膀胱癌的发病率和死亡率。

关键词: 膀胱癌, 全球疾病负担（GBD）, 发病率, 死亡率, 伤残调整寿命年（DALYs）
Objective

Bladder cancer (BC) is a major global public health concern and a leading cause of cancer-related mortality. This study aimed to analyze global, regional, and national epidemiological trends of BC from 1990 to 2021 and to predict future trends through 2050.

Methods

Data from the Global Burden of Disease (GBD) 2021 study were used to evaluate BC incidence, mortality, and disability-adjusted life years (DALYs) between 1990 and 2021. Predictions through 2050 were conducted using statistical modeling, key risk factors and the burden of BC across regions with varying social-demographic index (SDI) levels were analyzed.

Results

In 2021, there were 540 309.73 (95%UI: 494 720.89-582 579.44) new BC cases and 221 888.32 (95%UI: 200 567.17-242 326.46) deaths globally, resulting in 4 397 066.63 (95%UI: 4 063 656.74-4 813 655.42) DALYs. The highest incidence was observed in the Lebanese Republic, while Mali reported the highest mortality rate. Most cases and deaths occurred in high and high-middle SDI regions. Although the absolute numbers of incidence and deaths have increased over the past three decades, the age-standardized incidence rate (ASIR), mortality rate (ASMR), and DALYs rate (ASDR) have generally declined. Future predictions indicate continued global declines in ASIR, ASMR, and ASDR through 2050. Smoking and elevated fasting plasma glucose were identified as the primary risk factors.

Conclusion

The burden of bladder cancer varies significantly across regions and countries, highlighting the need for tailored prevention strategies. Reducing smoking and managing blood glucose levels help to lower BC incidence and mortality.

Key words: Bladder cancer, Global Burden of Disease (GBD), Incidence, Mortality, Disability-adjusted life-years (DALYs)
表1 1990年至2021年全球膀胱癌的发病、死亡及伤残调整寿命年情况
年份 总数 男性 女性
1990年      
新发患者数(95%UI，例） 260141.80(242823.27~272206.57) 195874.34(178071.68~207080.61) 64267.47(59326.98~67658.20)
死亡人数(95%UI，例） 123125.42(113327.44~129806.81) 89313.91(78994.92~95880.27) 33811.52(30883.10~35994.28)
DALYs (95%UI，例） 2733041.31(2471962.66~2894496.55) 2029728.61(1764128.35~2190170.59) 703312.70(648019.93~757679.22)
ASIR (95%UI，/10万) 6.90(6.46~7.23) 11.89(10.92~12.57) 3.11(2.86~3.28)
ASMR (95%UI，/10万) 3.51(3.23~3.70) 6.10(5.48~6.53) 1.71(1.55~1.82)
ASDR (95%UI，/10万) 71.05(64.72~75.17) 119.24(104.92~128.18) 33.58(30.78~36.07)
2021年      
新发患者数(95%UI，例） 540309.73(494720.89~582579.44) 417705.96(384651.52~456194.54) 122603.77(108167.18~133928.39)
死亡人数(95%UI，例） 221888.32(200567.17~242326.46) 164623.90(149887.24~182251.87) 57264.42(49416.75~62932.92)
DALYs (95%UI，例） 4397066.63(4063656.74~4813655.42) 3321535.72(3031701.10~3697557.48) 1075530.91(968388.95~1175822.65)
ASIR (95%UI，/10万) 6.35(5.80~6.85) 10.92(10.04~11.91) 2.64(2.34~2.89)
ASMR (95%UI，/10万) 2.68(2.42~2.93) 4.67(4.22~5.16) 1.22(1.06~1.34)
ASDR (95%UI，/10万) 51.58(47.56~56.42) 86.31(78.87~95.94) 23.29(20.99~25.45)
1990~2021年      
新发患者数变化率(95%UI，%） 107.70(92.80~129.45) 113.25(93.51~143.00) 90.77(75.09~109.04)
死亡人数变化率(95%UI，%） 80.21(65.50~101.48) 84.32(65.56~114.78) 69.36(53.20~87.72)
伤残调整寿命年变化率(95%UI，%） 60.89(46.58~83.13) 63.64(44.98~95.08) 52.92(37.35~71.54)
ASIR的EAPC (95%CI) -0.36(-0.42~0.30) -0.35(-0.40~0.29) -0.66(-0.73~0.58)
ASMR的EAPC (95%CI) -0.98(-1.04~0.93) -0.97(-1.01~0.92) -1.25(-1.32~1.18)
ASDR的EAPC (95%CI) -1.19(-1.25~1.13) -1.18(-1.23~1.13) -1.37(-1.44~1.29)
图1 2021年204个国家层面膀胱癌患病趋势注：a为膀胱癌新发患者数；b为膀胱癌死亡人数；c为伤残调整寿命年
图2 1990~2021年不同社会人口发展指数（SDI）地区膀胱癌负担趋势
图3 21个不同社会人口发展指数（SDI）水平地区层面膀胱癌负担趋势注：a为21个不同SDI水平地区ASIR；b为21个不同SDI水平地区ASMR；c为21个不同SDI水平地区ASDR
表2 1990~2021年五类SDI水平国家膀胱癌ASIR、ASDR及ASMR的EAPC
组别 ASIR (95%UI，/10万) ASIR的EAPC(95%CI) ASMR (95%UI，/10万)
1990 2021 1990 2021
低SDI 2.97(2.49~3.44) 2.95(2.56~3.42) -0.18(-0.29~0.07) 2.49(2.11~2.87) 2.26(1.97~2.63)
中低SDI 2.58(2.18~2.89) 2.64(2.32~3.48) -0.25(-0.40~0.10) 1.93(1.67~2.17) 1.68(1.48~2.21)
中SDI 3.23(2.71~3.58) 3.72(3.24~4.35) 0.31(0.22~0.40) 2.32(1.98~2.56) 1.89(1.65~2.20)
中高SDI 8.43(7.74~8.97) 8.24(7.53~9.15) -0.17(-0.27~0.07) 4.32(3.90~4.63) 3.25(2.94~3.60)
高SDI 11.20(10.70~11.56) 10.60(9.78~11.14) -0.19(-0.27~0.11) 4.35(4.07~4.52) 3.40(3.03-~3.61)
组别 ASMR的EAPC(95%CI) ASDR(95%UI，/10万) ASDR的EAPC(95%CI)
1990 2021
低SDI -0.45(-0.55~0.35) 51.93(44.13~59.85) 45.95(39.78~53.52) -0.56(-0.65~0.47)
中低SDI -0.65(-0.76~0.55) 41.49(35.19~46.52) 35.18(30.99~45.55) -0.80(-0.92~0.67)
中SDI -0.88(-0.97~0.79) 48.57(40.70~53.98) 37.63(33.12~43.70) -1.04(-1.13~0.94)
中高SDI -1.08(-1.18~0.98) 90.85(81.08~97.72) 63.84(58.43~70.77) -1.34(-1.45~1.24)
高SDI -0.83(-0.86~0.79) 87.92(83.98~91.16) 65.07(60.13~68.71) -1.00(-1.02~0.98)
图4 不同年龄人群在不同社会人口发展指数（SDI）水平国家层面的膀胱癌负担趋势注：a为基于年龄的膀胱癌发病率趋势；b为基于年龄的膀胱癌死亡率趋势；c为基于年龄的膀胱癌伤残调整寿命年（DALYs）率趋势
图5 不同性别人群的膀胱癌负担趋势注：a为基于性别的21个地区膀胱癌ASIR；b为基于性别的21个地区膀胱癌ASMR；c为基于性别的21个地区膀胱癌ASDR
图6 不同年龄与性别人群的膀胱癌负担趋势注：a为基于年龄与性别的膀胱癌ASIR；b为基于年龄与性别的膀胱癌ASMR；c为基于年龄与性别的膀胱癌ASDR
图7 基于危险因素的膀胱癌负担趋势注：a为五类SDI地区基于危险因素的膀胱癌负担；b为21个地区基于危险因素的膀胱癌负担；c为年龄基于危险因素的膀胱癌负担
图8 2021~2050年膀胱癌ASIR、ASMR及ASDR预测注：a为2021至2050年膀胱癌ASIR预测；b为2021至2050年膀胱癌ASMR预测；c为2021至2050年膀胱癌ASDR预测
图9 2021年至2050年不同年龄组膀胱癌发病率的预测趋势
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