Secular Trends in the Prevalence of Total and Latent Prostate Cancer over Half a Century According to Consecutive Autopsy Cases in a Japanese community: The Hisayama Study

Abstract

Background and objective

Our aim was to investigate secular trends in the period prevalence of total prostate cancer (PC) and latent PC (LPC) according to consecutive autopsy cases in a Japanese community.

Methods

A total of 1355 deceased men aged >40 yr in a Japanese community underwent consecutive autopsy examination between 1962 and 2020. The period prevalence of total PC and of LPC was calculated for 15-yr intervals, and secular trends were analyzed using a logistic regression model.

Key findings and limitations

The period prevalence of both total PC (from 1.7% in 1962–1976 to 19% in 2007–2020; p < 0.001) and LPC (from 1.3% in 1962–1976 to 11% in 2007–2020; p < 0.001) significantly increased over time (p_trend < 0.001). The age-specific period prevalence of total PC also increased for the age groups 60–79 yr (from 0.55% in 1962–1976 to 9.8% in 2007–2020; p = 0.005) and ≥80 yr (from 6.5% in 1962–1976 to 26% in 2007–2020; p = 0.003). There was no evidence of a secular change in the pathology of LPC.

Conclusions and clinical implications

The period prevalence of autopsy-proven total PC and LPC increased over the past 60 yr in a Japanese community. It is likely that this upward trend has involved additional factors beyond improvements in screening and diagnostic techniques or the aging of the population.

Patient summary

We used data from autopsy examinations in a Japanese population to analyze long-term trends for the occurrence of prostate cancer. We found a significant rise in the occurrence of both diagnosed prostate cancer and latent prostate cancer over the past 60 years in this Japanese community.