The burden of bladder cancer and kidney cancer attributable to smoking in Latin America and the Caribbean from 1990 to 2023 and projections to 2050.
INTRODUCTION Tobacco smoking is a major modifiable risk factor for bladder and kidney cancer. In Latin America and the Caribbean (LAC), comprehensive longitudinal evidence on the smoking-attributable burden of these cancers remains limited. This study assessed the burden, temporal trends, socioeconomic inequalities, and future projections of smoking-attributable bladder and kidney cancer in LAC. METHODS Data were obtained from the Global Burden of Disease (GBD) 2023 study to estimate deaths, disability-adjusted life years (DALYs), age-standardized mortality rate (ASMR), and age-standardized DALYs rate (ASDR) for smoking-attributable bladder and kidney cancer across 33 countries and territories in Latin America and the Caribbean from 1990 to 2023. Temporal trends were evaluated using joinpoint regression and average annual percent change (AAPC). Socioeconomic inequalities were assessed in relation to the sociodemographic index (SDI) using the slope index of inequality (SII) and concentration index (CIX). Future burden to 2050 was projected using a Bayesian age-period-cohort model. RESULTS In 2023, smoking-attributable bladder cancer caused an estimated 1742 deaths and 35903 DALYs in LAC, while kidney cancer caused 637 deaths and 14947 DALYs. From 1990 to 2023, ASMR and ASDR for both cancers showed overall declining trends, although substantial regional heterogeneity was observed, with the Caribbean showing increasing burden. At the national level, the burden of both cancers was positively associated with SDI in 2023. Projections to 2050 indicate that age-standardized rates will continue to decline, whereas the absolute numbers of deaths and DALYs will increase. CONCLUSIONS Age-standardized rates declined overall, whereas the absolute numbers of deaths and DALYs are projected to increase in Latin America and the Caribbean. Stronger tobacco control and better-prepared health systems are needed to address the growing cancer burden in aging populations.