Department of Breast Surgery, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
Department of Oncology, Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Cancer. 2020 Jan 1;126(9):1969-1978. doi: 10.1002/cncr.32733. Epub 2020 Feb 3.
The patterns of the incidence and mortality of prostate cancer (PC) have been changing over the years. In addition, the unclear etiology of PC necessitates further studies into the geographic distribution and age composition of patients with PC. This study was aimed at examining the patterns of the epidemiology of PC to help policymakers to allocate the limited resources of the health care system accordingly.
Annual case data and age-standardized rates (ASRs) were obtained for the incidence, mortality, and disability-adjusted life-years (DALYs) of PC according to age from 1990 to 2017 and for 21 regions, including 195 countries and territories. The estimated annual percentage changes (EAPCs) of ASRs were calculated to evaluate the incidence and mortality trends of PC.
Worldwide, the age-standardized incidence rate (ASIR) of PC increased from 30.5 cases per 100,000 population in 1990 to 37.9 cases per 100,000 population in 2017 with an EAPC of 0.59 (95% confidence interval [CI], 0.49-0.7), whereas the mortality decreased with an EAPC of -0.73 (95% CI, -0.80 to -0.67). The ASIR was positively associated with the sociodemographic index (SDI) in most regions, and the increase in the ASIR was steeper with a higher SDI. The proportion of patients younger than 65 years increased from 23.6% in 1990 to 27.3% in 2017.
The incidence of PC has been increasing globally, whereas its mortality and DALYs have been decreasing. These trends are particularly significant in developed regions and vary across geographic regions. Adjustments to the medical strategy by governments and medical institutions are required.
近年来,前列腺癌(PC)的发病率和死亡率模式一直在发生变化。此外,PC 的病因尚不清楚,需要进一步研究 PC 患者的地理分布和年龄构成。本研究旨在检查 PC 的流行病学模式,以帮助决策者相应地分配卫生保健系统的有限资源。
根据年龄从 1990 年到 2017 年获得了 195 个国家和地区 21 个地区的前列腺癌发病率、死亡率和伤残调整生命年(DALY)的年度病例数据和年龄标准化率(ASR)。计算了年龄标准化发病率(ASIR)的年估计百分比变化(EAPC),以评估 PC 的发病和死亡趋势。
全球范围内,1990 年每 100,000 人中有 30.5 例 PC,到 2017 年增加到每 100,000 人中有 37.9 例,EAPC 为 0.59(95%置信区间[CI],0.49-0.7),而死亡率则以 EAPC 的速度下降-0.73(95% CI,-0.80 至-0.67)。在大多数地区,ASIR 与社会人口学指数(SDI)呈正相关,并且随着 SDI 的升高,ASIR 的增加更为陡峭。年龄小于 65 岁的患者比例从 1990 年的 23.6%增加到 2017 年的 27.3%。
全球范围内 PC 的发病率一直在上升,而其死亡率和 DALY 则在下降。这些趋势在发达地区尤为显著,并且在地理区域之间有所不同。政府和医疗机构需要调整医疗策略。