Bladder cancer in Africa: burden, heterogeneity, demographic drivers, COVID-19 disruption, and projections to 2030

PurposeTo comprehensively characterize the burden, temporal trends, geographic heterogeneity, demographic drivers, pandemic-period deviations, and projected burden of bladder cancer across the African Union and 54 African countries from 2010 to 2023, with projections to 2030.MethodsWe performed a population-based secondary analysis using Global Burden of Disease Study 2023 estimates. Outcomes included incidence, prevalence, deaths, and disability-adjusted life-years (DALYs), assessed as counts and age-standardized rates (ASRs) per 100,000 population. Temporal trends were quantified using estimated annual percentage changes (EAPCs). Geographic heterogeneity was mapped, incidence trajectory phenotypes were identified using dynamic time warping–based clustering, changes in counts were partitioned using Das Gupta decomposition, COVID-19–period deviations were evaluated using autoregressive integrated moving average counterfactual models, and future burden was projected using log-linear models.ResultsFrom 2010 to 2023, bladder cancer burden in Africa increased substantially. At the African Union level, incident cases rose from 16,357 to 31,503, prevalent cases from 73,806 to 147,599, deaths from 9,261 to 16,467, and DALYs from 232,414 to 415,746. Corresponding ASRs increased from 3.5 to 4.4 per 100,000 for incidence, 13.9 to 18.3 for prevalence, 2.2 to 2.6 for deaths, and 48.1 to 56.1 for DALYs. High burden remained concentrated in North Africa and selected eastern and southeastern countries, whereas several historically lower-burden countries showed some of the fastest increases. Population growth was the leading driver of increasing counts, with additional contributions from population aging and epidemiological change. During 2020–2023, observed incidence, deaths, and DALYs exceeded prepandemic expectations. Most countries were projected to experience further increases through 2030.ConclusionBladder cancer burden in Africa increased markedly from 2010 to 2023 and is projected to continue rising in most countries through 2030. These increases were geographically heterogeneous and driven by both demographic and epidemiological forces, underscoring the need for regionally tailored prevention, diagnostic, and treatment strategies.