Abstract
PurposeThis study used data from the Global Burden of Disease Study 2019 (GBD 2019) to determine the differences in the incidence and mortality of prostate cancer (PCa) between China and the USA from 1990 to 2019.MethodThe age-standardized incidence rates (ASIRs) and age-standardized death rates (ASDRs) in China and the USA from 1990 to 2019 were extracted from GBD 2019. Annual percentage changes and relative risks of ASIR and ASDR were calculated using joinpoint regression analysis and age-period-cohort models, respectively.ResultsThe ASIR of PCa in China continually increased from 1990 to 2019, while in the USA it increased from 1990 to 1994 and then continually decreased until 2015, and then slightly increased again until 2019. The ASDR in China did not change, and the trend of ASDR in the USA was similar to the trend of the ASIR in the USA. The incidence of PCa increased with age in China, but decreased after the age of 75 years in the USA. A period effect was present, with the risk of developing PCa increasing continuously over longer time periods. Those born later had a lower risk of PCa or death, indicating a cohort effect.ConclusionPCa is becoming more problematic for Chinese males. Disease trends in the USA indicate that large-scale screening may be beneficial and should be immediately implemented among high-risk groups in China.
Highlights
In 2017, prostate cancer (PCa) was the most common cancer among males worldwide, with 1.7 million new cases, and its incidence has continually increased recently [1]
There was a continuously increasing trend for China, with age-standardize incidence rates (ASIRs) being 8.88/100,000 persons in 1990 and 17.34/100,000 persons in 2019 (AAPC = 2.30, 95% confidence interval (CI) = 2.10– 2.50)
The four joinpoints for China indicated that the increasing trend was most rapid from 2007 to 2010 (APC = 4.21, 95% CI = 2.48–5.97)
Summary
In 2017, prostate cancer (PCa) was the most common cancer among males worldwide, with 1.7 million new cases, and its incidence has continually increased recently [1]. The incidence, characteristics at onset (e.g., severity of disease and age at onset), and incidence trend of PCa vary markedly between countries [2]. The reasons for this include differences in the implementation of PCa screening and its policies, the specific risk genotypes of different races, and diet [3]. Understanding the differences in the changing trends of PCa burden between countries could identify favorable policy recommendations. China is encountering formidable healthcare challenges brought about by the problem of aging [7], coupled with increasingly westernized diet, resulting in the estimated incidence of PCa in China being increasing [8], which suggested the need for targeted screening programs
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