Global trends and regional variations in PCa burden: A focus on China's rapid growth.

Abstract

Background: Prostate cancer (PCa) is a leading malignancy among men globally, with varying incidence across regions. While high-income countries have effectively controlled PCa through early detection and treatment, middle- and low-income regions, including China, are experiencing rising incidence rates. Understanding these trends is crucial for effective prevention and management.

Methods: Utilizing data from the Global Burden of Disease (GBD) database, we analyzed global and regional trends in age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) for PCa from 1990 to 2021. Bayesian Age-Period-Cohort (BAPC) models and Join-point regression were employed to assess temporal trends and project future incidence rates until 2035. Regional disparities were examined across Socio-Demographic Index (SDI) levels.

Results: Globally, the ASIR of PCa modestly increased from 32.6 to 34.1 per 100,000 (1990-2021), while ASMR and DALYs significantly declined in high-SDI regions, reflecting advancements in screening and treatment. In contrast, middle- and low-SDI regions showed rising incidence rates, limited mortality reductions, and persistent disease burdens. In China, ASIR rose from 5.0 to 9.3 per 100,000 (EAPC: 1.834) and is projected to reach 14.7 by 2035, driven by an aging population, improved screening, and lifestyle changes. However, ASMR in China remained stable, and DALYs slightly increased, indicating a sustained disease burden.

Conclusion: The increasing incidence and persistent burden of PCa in middle- and low-SDI regions, including China, necessitate targeted strategies. Enhancing prostate-specific antigen screening, reducing overdiagnosis, improving healthcare accessibility, and promoting lifestyle changes.