Global burden of prostate cancer: regional disparities in incidence, mortality, and survival

Objectives: This article aims to provide a comprehensive overview of the worldwide burden of prostate cancer by exploring its global incidence, mortality, and survival. Material and methods: Incidence rates were extracted from the CI5plus and NORDCAN databases. Prostate cancer deaths and populations were extracted from the WHO mortality database. For both incidence and mortality, age-standardised rates per 100,000 person-years (PY) were computed. Age-stand-ardised relative survival was retrieved from the SEER database and the Eurocare-5, NORDCAN, and SURVCAN projects. For incidence and mortality, mean rates and annual percent changes (APC) over the last 10 years were computed. Results: Recent incidence rates varied more than 25-fold across countries, ranging from 6.2 to 119 per 100,000 PY in India and Brazil, respectively. Mortality rates also showed important disparities, ranging from 2.5 to 21.0 per 100,000 PY in Thailand and Estonia, respectively. Over the period 2003-2012 the incidence increased in 17 out of 26 countries. Over the period 2006-2015 the mortality decreased in 23 out of 30 countries. Age-standardised five-year survival from prostate cancer was very high and ranged from 34.8% in India to 90.0% in Finland. Survival trends in the USA and Northern Europe showed an increase starting in the 1970s and reached almost 100% in recent years. Survival was poorer for distant stages (approximately 30%), compared to localised and regional stages (almost 100%). Conclusions: Large variations in incidence and mortality were observed across countries, but survival rates remained high. Screening practices should be considered when interpreting these results because they largely influence incidence and survival.