Prostate cancer incidence in 43 populations worldwide: An analysis of time trends overall and by age group
Open accessAbstract
Prostate cancer is a significant public health burden and a major cause of morbidity and mortality among men worldwide. Analyzing geographic patterns and temporal trends may help identify high‐risk populations, suggest the degree of PSA testing, and provide clues to etiology. We used incidence data available from the International Agency for Research on Cancer (IARC) and certain cancer registries for 43 populations across five continents during a median period of 24 years. Trends in overall prostate cancer rates showed five distinct patterns ranging from generally monotonic increases to peaking of rates followed by declines, which coincide somewhat with changes in the prevalence of PSA testing. Trends in age‐specific rates generally mirrored those in the overall rates, with several notable exceptions. For populations where overall rates increased rapidly and then peaked, exemplified in North America and Oceania, the highest incidence tended to be most pronounced and occurred during earlier calendar years among older men compared with younger ones. For populations with almost continual increases in overall rates, exemplified in Eastern Europe and Asia, peaks were evident among men aged ≥75 years in many instances. Rates for ages 45–54 years did not clearly stabilize or decline in the majority of studied populations. Global geographic variation remained substantial for both overall and age‐specific incidence rates regardless of levels of PSA testing, with the lowest rates consistently in Asia. Explanations for the persistent geographic differences and the continuing increases of especially early‐onset prostate cancer remain unclear.
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The rapid increases in prostate cancer incidence were followed by equally pointed reductions within a few years, likely reflecting a depletion of prevalent cancers.
“The increases were followed by equally pointed reductions within a few years, likely reflecting a depletion of prevalent cancers”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [87]
The Results (page unavailable) report rapid incidence increases followed by declines in four populations, but rates plateaued in three others and resumed increasing in Australia. The Discussion (page unavailable) suggests that earlier diagnosis and fewer positive results with repeated PSA screening may partly explain declines at older ages. It does not establish equally sharp reductions within a few years or attribute the overall pattern specifically to depletion of prevalent cancers. (LLM, conf=0.85)
Experimental — accuracy not yet measuredDeclines in prostate cancer incidence thereafter are largely attributed to a reduction in the use of PSA testing, reflecting changes in PSA-based screening guidelines.
“with declines thereafter largely attributed to a reduction in the use of PSA testing, [87][88][89][90][91] reflecting changes in PSA-based screening guidelines.[92][93][94][95]”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [87]
The Discussion says declining incidence among men aged 75 and older may be partly due to reduced PSA screening, but also points to diagnoses at younger ages. It reports that PSA testing did not consistently decrease in that age group and says the effect of changing guidelines on screening behavior remains unclear. The paper therefore does not support attributing the declines largely to reduced testing driven by guideline changes. (LLM, conf=0.86)
Experimental — accuracy not yet measuredDifferences in diagnostic practices at the national level are a driving factor explaining much of the marked variations in prostate cancer incidence worldwide.
“Differences in diagnostic practices at the national level are a driving factor explaining much of the marked variations in prostate cancer incidence worldwide.87”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [87]
The Discussion says differences in PSA testing across countries have greatly influenced some incidence trends, supporting a role for diagnostic practices. But it also says considerable geographic variation persists regardless of PSA testing and that not all patterns can be explained by screening. The source therefore does not establish that diagnostic differences explain much of the worldwide variation. (LLM, conf=0.85)
Experimental — accuracy not yet measuredIn greater Europe, Southern and Central America, and Asia, later, less emphatic prostate cancer incidence trends have been reported, reflecting a more recent and moderate adoption of PSA testing.
“In greater Europe, Southern and Central America, and Asia, later, less emphatic trends have been reported, reflecting a more recent and moderate adoption of PSA testing.[86][87][88]98”
From Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. (2024) · cites this paper as [87]
The Results describe later or more gradual incidence increases in some studied populations, and the Discussion links slower PSA uptake to more gradual increases in some countries. But the Results also report rapid increases in Brazil, Korea, and several European populations. The Discussion cautions that PSA-testing data are incomplete and that the contribution of testing to incidence trends cannot be precisely disentangled, so the claimed regional pattern and explanation are too broad and definite. (LLM, conf=0.86)
Experimental — accuracy not yet measured
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“87 In North America, selected Nordic countries, and Australia, there were rapid increases in incidence rates from the late 1980s to the early 1990s as a result of the widespread introduction of prostate ‐ specific antigen (PSA) testing.”
BackgroundSelf-citationWong, M. C. S., Goggins, W. B., Wang, H. H. X., Fung, F. D. H., Leung, C., Wong, S. Y. S., Ng, C. F., & Sung, J. J. Y. (2016) · European Urology · doi:10.1016/j.eururo.2016.05.043 · Cited by 513 · see citing works
- Authors
- Zhou, C. K., Check, D. P., Lortet‐Tieulent, J., Laversanne, M., Jemal, A., Ferlay, J., Bray, F., Cook, M. B., & Devesa, S. S.
- Affiliations
- National Institutes of Health (US)
- American Cancer Society (US)
- Centre international de recherche sur le cancer (FR)
- Corresponding author
- Zhou, Cindy Ke
- ORCID
- Venue
- International Journal of Cancer
- Publisher
- Wiley
- Published
- 2015-11-27
- Volume
- 138
- Issue
- 6
- Pages
- 1388-1400
- ISSN
- 0020-7136 (ISSN-L)
- 1097-0215
- PMC
- PMC4712103
- OpenAlex
- W2096619957
- Cited by
- 322
- References
- 48
- Citations by year
- 2026: 14 · 2025: 29 · 2024: 26 · 2023: 13 · 2022: 46 · 2021: 36 · 2020: 44 · 2019: 33 · 2018: 36 · 2017: 27 · 2016: 18
- FWCI
- 11.79
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- International Journal of Cancer (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Intramural Program of the Division of Cancer Epidemiology and Genetics
- National Cancer Institute
- National Institutes of Health
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Prostate Cancer Treatment and Research
- Keywords
- prostate cancer, cancer incidence, temporal trends, age-specific incidence, PSA screening, regional variation, early-onset prostate cancer, cross-national comparison, cancer etiology
- MeSH terms
- Adolescent, Adult, Age Factors, Aged, Aged, 80 and over, Humans, Male, Middle Aged, Population Surveillance, Prostatic Neoplasms, Global Health, Incidence, Databases, Factual, History, 20th Century, History, 21st Century, Young Adult
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