Disparities in the Burden of Prostate Cancer and Its Trends in the Western Pacific Region, 1990-2021.
Abstract
Objective
We assessed long-term and recent trends, age and geographic disparities, and future prostate cancer (PC) burden in China, the Western Pacific Region (WPR), individual WPR locations, and globally from 1990 to 2021, with projections through 2035.
Methods
We analyzed Global Burden of Disease Study 2021 estimates of incidence, mortality, prevalence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life years (DALYs) for China, WPR locations, sociodemographic index strata, and globally. Absolute numbers and age-standardized rates were examined separately. Joinpoint regression estimated average annual percent changes (AAPCs) for 1990-2021 and 2012-2021. Bayesian age-period-cohort models projected incidence and deaths for 2022-2035; projected YLLs and YLDs were combined to estimate DALYs.
Results
In 2021, the WPR had an estimated 192,632 incident cases (95% UI, 159,855-227,328) and 69,365 deaths (95% UI, 56,577-83,449). During 1990-2021, age-standardized incidence and prevalence increased (AAPC, 1.64% and 2.40%), whereas mortality and the age-standardized DALY rate (ASDLR) were stable (0.00% and 0.02%). ASDLR declined in high-SDI and high-middle-SDI locations but increased in lower SDI locations, and burden rose steeply with age. During 2012-2021, age-standardized incidence and mortality declined (AAPC, -0.28%; 95% CI, -0.56% to -0.06%; p = 0.014; and -0.58%; 95% CI, -0.76% to -0.40%; p < 0.001), but country-level trends were heterogeneous. From 2022 to 2035, posterior mean ASDLR increased modestly in China and the WPR and declined globally; projected mean absolute DALYs increased in all three settings, with widening uncertainty.
Conclusion
Absolute PC burden increased substantially in the WPR, whereas age-standardized patterns varied across measures, periods, age groups, SDI strata, and countries. Recent regional declines did not indicate uniform improvement, and projected increases in absolute DALYs suggest continuing growth in service needs. Locally adapted prevention, risk-appropriate early detection, diagnosis, and treatment planning are required.