先前的研究报告了美国各种泌尿生殖系统癌症的发病率和死亡模式。然而，这些研究的重点是各种癌症类型而非总体泌尿生殖系统癌症。为了全面检查美国四种主要泌尿生殖系统癌症（膀胱癌、肾癌、前列腺癌和睾丸癌）的发病率和死亡率的不平等和趋势，我们使用美国癌症研究所22个区域的监测、流行病学和结果数据（SEER）数据库和美国疾病控制和预防中心的美国癌症统计数据库获取发病率数据，并使用全国卫生统计中心的死亡数据，通过性别、种族/族裔和县进行分层，使用SEER*Stat软件计算年龄调整后的发病率和死亡率。使用Joinpoint回归分析了时间趋势，显著性水平为双侧p<0.05。男性膀胱癌和肾癌的发病率和死亡率是女性的两到四倍。在非西班牙裔白人中，膀胱癌的最高发病率在东北部，肾癌的最高发病率在阿巴拉契亚山区，而前列腺癌的最高死亡率在西部。在几乎所有种族/族裔中，肾癌和睾丸癌的发病率以及晚期前列腺癌的发病率都有所增加，美洲印第安人/阿拉斯加原住民人群的膀胱癌发病率也有所增加。西班牙裔人口睾丸癌的死亡率上升，而自上世纪90年代初以来，白人和亚裔/太平洋岛民男性前列腺癌的死亡率趋于稳定。研究限制包括医疗记录和死亡证明上的种族/族裔错误分类。我们发现所有四种主要泌尿生殖系统癌症的社会人口学差异和不利趋势仍然存在，未来的研究应该阐明这些模式的原因。在美国，总体人口的肾癌、睾丸癌和晚期前列腺癌的癌发病率正在增加，而美洲印第安人/阿拉斯加原住民人群的膀胱癌的发病率也在增加。不同性别和种族/族裔的癌症发生率差异仍然存在。版权所有©2022作者。由Elsevier B.V.出版。保留所有权利。

Previous studies have reported on incidence and mortality patterns for individual genitourinary cancers in the USA. However, these studies addressed individual cancer types rather than genitourinary cancers overall.To comprehensively examine disparities and trends in the incidence and mortality for the four major genitourinary cancers (bladder, kidney, prostate, and testis) in the USA.We obtained incidence data from the National Cancer Institute 22-registry Surveillance, Epidemiology and End Results (SEER) database and the US Cancer Statistics database (Centers for Disease Control and Prevention) and mortality data from the National Center for Health Statistics to examine cross-sectional and temporal trends in incidence and death rates stratified by sex, race/ethnicity, and county.Age-adjusted incidence and death rates were calculated using SEER*Stat software. Temporal trends were analyzed using Joinpoint regression for a two-sided significance level of p < 0.05.Incidence and mortality rates for bladder and kidney cancers were two to four times higher for men than for women. Among non-Hispanic White individuals, the highest incidence rates were found in the Northeast for bladder cancer and in Appalachia for kidney cancer, whereas the highest death rates for prostate cancer were found in the West. Incidence rates increased for cancers of the kidney and testis and for advanced-stage prostate cancer in almost all racial/ethnic populations and for bladder cancer in the American Indian/Alaska Native population. Death rates increased for testicular cancer in the Hispanic population and stabilized for prostate cancer among White and Asian American/Pacific Islander men after a steady decline since the early 1990s. Study limitations include misclassification of race/ethnicity on medical records and death certificates.We found persistent sociodemographic disparities and unfavorable trends in incidence or mortality for all four major genitourinary cancers. Future studies should elucidate the reasons for these patterns.In the USA, rates of cancer cases are increasing for kidney, testis, and advanced-stage prostate cancers in the overall population, and for bladder cancer in the American Indian/Alaska Native population. Differences in the rates by sex and race/ethnicity remain.Copyright © 2022 The Author(s). Published by Elsevier B.V. All rights reserved.