Department of Surgery, Division of Urology, University of Colorado Anschutz School of Medicine, Aurora, Colorado, USA.
Department of Surgery, Division of Urology, Rocky Mountain Regional VA Medical Center, University of Colorado Anschutz School of Medicine, Aurora, Colorado, USA.
Prostate. 2021 Sep;81(12):825-831. doi: 10.1002/pros.24178. Epub 2021 Jul 5.
Considered globally, prostate cancer is a disease of the aging male that increases in prevalence with exposure to screening and diagnostic testing, and which requires a population with the health and longevity to encounter it. The Global Burden of Disease (GBD) dataset is an aggregation of worldwide registries and health data systems that reports global and regional assessment of disease impact.
Using the GBD database, 1171 worldwide registries and health registration systems from 1990 to 2016 were aggregated for prostate cancer disease codes and outcomes. Disease-Adjusted Life Years (DALYs) were calculated and segregated by sociodemographic index (SDI) quintile, and compared to other urologic diseases and tuberculosis (TB).
Prostate cancer exerts a burden of disease that is vastly higher in the top quintile of SDI. The three lowest SDI quintiles represent the majority of global population but are currently less impacted by prostate cancer. Conversely, TB has its highest impact on the lowest SDI levels, although these rates are declining.
As a global disease, prostate cancer predominantly affects high SDI men who enjoy a longer life expectancy in which to suffer from this disease and a greater exposure to screening and diagnosis. As lower SDI men are elevated in health and income, reallocation of DALYs will occur, and a greater burden of prostate cancer can be expected. These epidemiologic trends have great implications for the allocation of resources, as the population of men affected by prostate cancer outpaces urologic workforce growth.
从全球范围来看，前列腺癌是一种老年男性疾病，随着筛查和诊断检测的普及，其发病率不断上升，而且需要有一定健康水平和寿命的人群才能患上这种疾病。全球疾病负担（GBD）数据集是一个全球范围内的注册和健康数据系统的集合，它报告了全球和区域疾病影响的评估。
利用 GBD 数据库，我们汇总了 1990 年至 2016 年来自全球 1171 个注册处和健康登记系统的前列腺癌疾病代码和结果数据。我们计算了疾病调整生命年（DALY），并按社会人口指数（SDI）五分位数进行了细分，同时与其他泌尿系统疾病和结核病（TB）进行了比较。
前列腺癌在 SDI 最高的五分位数中造成的疾病负担要大得多。SDI 最低的三个五分位数代表了全球大部分人口，但目前受前列腺癌的影响较小。相反，结核病对最低 SDI 水平的影响最大，尽管这些比率正在下降。
作为一种全球性疾病，前列腺癌主要影响 SDI 较高的男性，他们的预期寿命更长，有更多的机会患上这种疾病，并且更有可能接受筛查和诊断。随着较低 SDI 男性的健康水平和收入水平提高，DALY 将重新分配，预计前列腺癌的负担将会增加。这些流行病学趋势对资源分配具有重要意义，因为受前列腺癌影响的男性人口增长速度超过了泌尿外科劳动力的增长速度。
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