GBD risk factors are estimated based on a comparative risk assessment framework which includes six steps. First, the identification of risk-outcome pairs: only those risk-outcomes, which have convincing or plausible evidence according to the World Cancer Research Fund criteria (12 ), will be involved in GBD risk factor estimation. Second, relative risk (RR) as a function of exposure for each risk-outcome pair is estimated. Third, exposure for each risk factor is distributed by age, sex, location, and year. Fourth, the theoretical minimum risk exposure level (TMREL) is demonstrated. Fifth, the population attributable fraction (PAF) and attributable burden are measured. The PAF is modeled by the RR for each risk-outcome pair, exposure levels, and TMRE L (9 (link)). The PAF of a particular risk factor is compounded by genitourinary cancer mortality to engender the mortality attributable to that risk factor. Finally, the PAF and attributable burden for the combination of risk factors are estimated. The methodology of these steps has been comprehensively reviewed in previously published articles (9 (link)). Four [high body-mass index (BMI) for kidney cancer, occupational exposure to trichloroethylene for kidney cancer, high fasting plasma glucose for bladder cancer, and smoking for kidney, bladder and prostate cancer] of the 87 risk factors included in this GBD iteration have a non-zero contribution to the mortality of genitourinary cancers deaths. The percentage contribution of these four risk factors to genitourinary cancers is assessed.
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