Global epidemiological trends in prostate cancer burden: a comprehensive analysis from Global Burden of Disease Study 2021.

Abstract

Background: Prostate cancer (PC) remains a major global health concern, with significant geographic and ethnic disparities in incidence and mortality. While the widespread use of prostate-specific antigen screening has improved early detection, ongoing debates regarding overdiagnosis and overtreatment raise concerns about its clinical utility and cost-effectiveness. Previous studies have examined regional variations in disease burden, yet gaps persist in understanding long-term epidemiological trends and the influence of sociodemographic factors. A standardized, comprehensive analysis is essential to guide evidence-based prevention and control strategies. This study investigated PC incidence, mortality, prevalence, and disability-adjusted life years (DALYs) between 1990 and 2021, providing a detailed assessment of its global burden. By analyzing temporal and regional trends, this study seeks to inform targeted prevention efforts and optimize healthcare resource allocation.

Methods: Data were analyzed for annual incident cases, deaths, prevalence, DALYs, age-standardized incidence rates (ASIRs), age-standardized death rates (ASDRs), and age-standardized prevalence rates (ASPRs) for PC from 1990 to 2021, using data from the Global Burden of Disease (GBD) Study 2021. Temporal trends were assessed by calculating percentage changes in incident cases, deaths, and DALYs, along with estimated annual percentage changes (EAPCs) in ASIR, ASDR, ASPR, and DALYs. Pearson correlation analyses were conducted to evaluate the relationship between EAPCs and the socio-demographic index (SDI). Joinpoint regression was applied to identify significant shifts in these metrics over time.

Results: The analysis reveals a 161.53% increase in global PC incidence and a 0.568% rise in prevalence, while mortality rates have declined by 0.83%. Regional variations are evident, with Eastern Europe and South Asia experiencing a higher burden of disease. Age distribution analysis shows that PC predominantly affects older populations, particularly individuals aged 70 years and above. SDI analysis indicates a positive correlation between SDI and PC prevalence, while the association with DALYs is comparatively weaker. Additionally, high-income regions such as Bermuda, Antigua, and Barbuda exhibit significant disparities in disease burden.

Conclusions: PC remains a growing global burden with significant regional and age-related disparities. While higher SDI regions show increased prevalence, the weaker correlation with DALYs suggests that healthcare access alone does not fully alleviate disease burden. These findings emphasize the need for targeted strategies that integrate early detection with equitable treatment and long-term management to reduce disparities and improve outcomes.