Aging and prostate health: meta-analytic insights into age-related prostatic disorders

Prostate health conditions, including benign prostatic hyperplasia (BPH) and prostate cancer (PCa), have historically been linked to aging. Nevertheless, previous studies have not sufficiently addressed detection bias arising from increased prostate screening in older males, which may have artificially inflated incidence rates. This systematic review and meta-analysis aimed to synthesize available evidence on the relationship between aging and prostate disorders while accounting for potential detection bias.

A systematic literature search was conducted across PubMed, Scopus, Web of Science, Google Scholar, and the NCBI Trials registry for studies published up to June 2024. Studies reporting age-related prevalence of risk estimates for PCa or BPH were included. Pooled prevalence estimates were synthesized using both fixed-effects and random-effects meta-analytic models. Between-study heterogeneity was assessed using Cochran's Q test and the I² statistic.

Eighteen studies (12 on PCa and six on BPH) involving 21483 participants were included in the final analysis. Under the random-effects model, the pooled prevalence estimate for PCa was 0.966 (95% CI: 0.886-0.991), while pooled prevalence estimate for BPH was 0.132 (95% CI: 0.068-0.241). substantial between-study heterogeneity was observed (I² >95%). These pooled estimates represent summary prevalence proportions rather than comparative odds ratios and therefore reflect the burden of prostate disorders across aging male populations rather than causal risk effects.

This meta-analysis demonstrates a substantial prevalence of prostate disorders in aging male populations. However, considerable heterogeneity across studies suggests that differences in population characteristics, study design, and screening intensity may influence the observed associations. These findings highlight the need for future epidemiological studies that better distinguish biological aging effects from diagnostic and surveillance-related factors.

https://www.crd.york.ac.uk/prospero/, identifier CRD420251021675.