Epidemiologic aspects of latent and clinically manifest carcinoma of the prostate.

The worldwide incidence of prostate cancer differs greatly. The black population of the USA is at the head, while the Asian populations have the lowest incidence and mortality rates. Comparative geographic-pathologic autopsy studies on frequency nd growth type of latent prostate carcinomas show that in populations with a lower incidence, for example Japan and Singapore, latent carcinomatous foci are not considerably rarer than in regions with high incidence. However, obvious differences are seen when comparing the size of the foci and the growth types. In countries with low incidence and mortality rate, the foci of the latent prostate carcinoma are small and show a slight proliferating tendency, whereas in countries with high incidence and mortality rate, they are frequently larger and more aggressive. Consequently, the different incidence of prostate cancer is not based on different initiation of malignant transformation, but on different promoting factors. In histologic-bioptical specimens from regions with high incidence and mortality rate, pluriform tumor types of malignancy grade G III and G II prevail. Definite causes of prostate cancer could not be detected by case control and migration studies up to now.