Liu Xiaomu, Jiang Haiou
Department of Geriatrics, The First Hospital of China Medical University, Shenyang, China.
Department of Neurology, The First Hospital of China Medical University, Shenyang, China.
Front Public Health. 2025 May 21;13:1553747. doi: 10.3389/fpubh.2025.1553747. eCollection 2025.
The rising annual incidence of prostate cancer (PCa) has become a significant health challenge for men worldwide. The study aims to estimate the contemporary disease burden of PCa across global, regional, and national levels.
Data from the Global Burden of Disease Study 2021 (GBD 2021) was analyzed to evaluate trends in PCa incidence, prevalence, disability-adjusted life years (DALYs), and mortality from 1990 to 2021. Determinants of PCa burden were investigated through Spearman correlation analysis with socio-demographic index (SDI), decomposition analysis, and frontier analysis to assess regional improvement potential.
In 2021, global PCa incidence reached 1.32 million cases [95% uncertainty interval (UI): 1217320.93, 1400222.17]. Between 1990 and 2021, the global estimated annual percentage change (EAPC) of age-standardized incidence rates (ASIR), prevalence rates (ASPR), DALYs rates (ASDR), and mortality rates (ASMR) were declined or increased at -0.06% [95% confidence interval (CI): -0.21, 0.08], 0.42% (95% CI: 0.26, 0.58), -0.96% (95% CI: -1.05, -0.87), and -0.58% (95% CI: -0.73, -0.44), respectively. Low-middle SDI countries exhibited the steepest rate increases, with males over 50 years being most affected. Significant positive correlations emerged between SDI levels and ASIR ( = 0.543, < 0.001) or ASPR ( = 0.709, < 0.001), whereas EAPC of ASDR ( = -0.430, < 0.001) or ASMR ( = -0.450, < 0.001) inversely correlated with SDI among 204 countries and territories. Decomposition analysis revealed the global increase of DALYs for PCa was predominantly attributed to aging (77.65%) and population growth (58.59%). Frontier analysis identified substantial improvement potential across development spectra, particularly in middle to high SDI regions.
Our findings demonstrated that despite modest declines in ASDR and ASMR within high SDI regions, PCa burden metrics persistently increased in low-middle SDI quintiles. Nations across all development levels require urgent implementation of evidence-based policies and precision management strategies to mitigate this growing public health challenge.
前列腺癌（PCa）的年发病率不断上升，已成为全球男性面临的重大健康挑战。本研究旨在评估全球、区域和国家层面PCa的当代疾病负担。
分析全球疾病负担研究2021（GBD 2021）的数据，以评估1990年至2021年期间PCa发病率、患病率、伤残调整生命年（DALYs）和死亡率的趋势。通过与社会人口指数（SDI）的Spearman相关分析、分解分析和前沿分析来研究PCa负担的决定因素，以评估区域改善潜力。
2021年，全球PCa发病率达到132万例[95%不确定区间（UI）：1217320.93，1400222.17]。1990年至2021年期间，年龄标准化发病率（ASIR）、患病率（ASPR）、伤残调整生命年率（ASDR）和死亡率（ASMR）的全球估计年变化百分比（EAPC）分别下降或上升了-0.06%[95%置信区间（CI）：-0.21，0.08]、0.42%（95%CI：0.26，0.58）、-0.96%（95%CI：-1.05，-0.87）和-0.58%（95%CI：-0.73，-0.44）。中低SDI国家的发病率增长最为显著，50岁以上男性受影响最大。SDI水平与ASIR（r = 0.543，P < 0.001）或ASPR（r = 0.709，P < 0.001）之间存在显著正相关，而在204个国家和地区中，ASDR（r = -0.430，P < 0.001）或ASMR（r = -0.450，P < 0.001）的EAPC与SDI呈负相关。分解分析表明，全球PCa伤残调整生命年的增加主要归因于老龄化（77.65%）和人口增长（58.59%）。前沿分析确定了不同发展水平地区存在显著的改善潜力，特别是在中高SDI地区。
我们的研究结果表明尽管高SDI地区的ASDR和ASMR略有下降，但中低SDI五分位数地区的PCa负担指标持续上升。所有发展水平的国家都需要紧急实施基于证据的政策和精准管理策略，以应对这一日益严峻的公共卫生挑战。
