Background
Prostate cancer's (PC) burden and its temporal trend have been poorly studied. This study aimed to fill this gap by evaluating regional disparities of PC burden and trends in China, the Western Pacific Region (WPR), and the World from 1990 to 2019.
Methods
According to the estimation of prostate cancer disease burden in the global burden of disease 2019 (GBD 2019), we applied GBD 2019 analytical tools to compare PC incidence, mortality, prevalence, the years lived with disability (YLDs), years of life lost (YLLs) and disability-adjusted life-years (DALYs) from 1990 to 2019 in China, the WPR, and the World. Disease burden trends between 1990 and 2019 were evaluated using average annual percent change (AAPC) estimated by Joinpoint regression analysis.
Results
There were 268434.51 (95% UI: 229573.18, 329220.58) new PC cases, 2044006.62 (95% UI: 1749910.09, 2541958.35) PC patients, and 90275.23 (95% UI: 76005.63, 109056.31) deaths due to PC in 2019 in the WPR. The trend for DALYs (AAPC=-0.31 (95% CI=-0.35, -0.27)%, P < 0.001) decreased. With the increase in age, PC incidence (AAPC = 91.07 (95%CI = 77.40, 105.79)%, P < 0.001), mortality (AAPC = 114.62 (95%CI = 102.49, 127.48)%, P < 0.001), YLLs (AAPC = 84.23 (95%CI = 74.18, 94.86)%, P < 0.001), and DALYs (AAPC = 84.61 (95%CI = 74.25, 95.60)%, P < 0.001) rates increased notably. Our analysis shows regional differences in PC burden in the WPR from 1990 to 2019. The PC burden in most high-income countries decreased (High-Socio-Demographic-Index (SDI) countries: AAPC 95%CI=-1.46(-1.55, -1.38)%, P < 0.001). The age-standardized DALYs of PC increased in most low-income countries (Low-SDI countries: AAPC 95%CI = 0.41(0.35, 0.47)%, P < 0.001). The age-standardized DALYs of PC in middle-income countries increased or had no apparent changes, except in China (AAPC=-0.24(95% CI=-0.27, -0.2)%, P < 0.001) and Kiribati (AAPC=-0.62(95% CI = -0.83, -0.41)%, P < 0.001), which decreased.
Conclusions
There was a growing burden and profound imbalance in prostate cancer from 1990 to 2019 in the WPR. Our study emphasized the urgent need for tailored prevention and control strategies for PC to reduce disparities in the PC burden and promote health governance in the WPR. Public health strategies effective in high-income countries and some countries in the WPR could be used as references for developing PC prevention and intervention strategies according to local conditions.