Global Dual Incidence-Mortality Patterns of Prostate Cancer Across SDI Regions, 1990-2021: A Cross-Sectional Study...

To facilitate the development of precision prevention and control measures, this research offers a comprehensive evaluation of the global prostate cancer landscape, with a specific focus on its incidence, mortality rates, and underlying risk factors.

We retrieved data on prostate cancer incidence, fatalities, and disability-adjusted life-years (DALYs) across 204 nations and territories from the Global Burden of Disease (GBD 2021) study. Trends were assessed via estimated annual percentage changes (EAPC), with further stratification by age and the socio-demographic index (SDI).

Globally, prostate cancer cases and deaths reached 1.32 million and 432,000 in 2021, marking a substantial rise of 162% and 104% compared to 1990 levels. While the global age-standardized incidence rate (ASIR) remained stable, it rose significantly in low-SDI regions (EAPC = 0.69%) and declined in high-SDI regions (EAPC = -0.36%). The global age-standardized mortality rate (ASMR) decreased (EAPC = -1.05%), and the age-standardized DALY rate showed a similar downward trend, with higher rates in low-SDI regions. Mortality in low-SDI regions (16.8/100,000) surpassed that in high-SDI regions (15.35/100,000). Incidence peaked at ages 70-74, whereas mortality peaked at ≥ 85 years. Tobacco control and dietary interventions are beneficial, but their population impact is modest in low-SDI regions.

Prostate cancer burden follows a dual pattern: ASIR increases with SDI, while ASMR and DALY rates decrease. High-SDI regions have reduced mortality through screening/treatment advances, whereas low-SDI regions face rising incidence and persistently high mortality. Although tobacco control and diet help, their attributable fractions are modest; health‑system strengthening for early detection and treatment access is the priority in low‑SDI settings.