Evolving Global Trends in Prostate Cancer: Disparities Across Income Levels and Geographic Regions (1990-2019).

Purpose: Variability in prostate cancer (PC) incidence and mortality reflects the substantial burden of the disease, shaped by factors such as socioeconomic variables, health care access, screening practices, and therapeutic treatments. This study assesses the trends in incidence, mortality, and disability-adjusted life years (DALYs) in PC among varying country income levels and WHO regions.

Methods: Global Burden of Disease Study database was used to extract age-standardized incidence rates (ASIRs), age-standardized mortality rates (ASMRs), and DALYs for PC among six WHO regions and four World Bank regions based on income levels from 1990 to 2019. Mortality-to-incidence ratios (MIRs) were computed. Joinpoint regression analysis was conducted to calculate the estimated annual percentage change.

Results: Between 1990 and 2019, ASIRs increased across all income level countries, with the greatest increase in the upper-middle-income countries (+64.7%). In the past 30 years, high-income countries have consistently observed the highest ASIR (2019: 77.5 per 100,000). High mortality rates were observed in low-income countries despite low ASIR overall. ASMRs increased in low-income countries (+14.3%), compared with a decrease in high- and upper-middle-income countries. DALYs also increased in low-income countries (+13.8%) compared with a decrease in high-income countries (-25.7%). MIRs decreased in all countries, with the largest decrease in high-income countries (-50%). In 2019, the highest MIR (1 per 100,000) was observed in low-income countries.

Conclusion: The divergent trends in PC outcomes across income levels, such as a rise in mortality and DALYs in low-income countries, reflect global health care inequities that highlight the urgent unmet need for improving cancer screening, diagnosis, and treatment access in resource-limited settings.