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

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.

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.

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.

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.