Global, regional, and national burden and trends of prostate cancer in elderly from 1990 to 2021: results from global burden of disease 2021.

BACKGROUND

Emerging evidence has demonstrated marked geographical and demographic variations in prostate cancer (PC) incidence and mortality rates. As PC predominantly affects the elderly, in-depth analysis of disease trends in this vulnerable population is imperative.

METHODS

This study leveraged data from the Global Burden of Disease Study (GBD) 2021 to systematically evaluate temporal trends in the incidence, mortality, and Disability-Adjusted Life Years (DALYs) of PC in elderly aged 70 and above. The analyses were stratified by age group, geographic region, and Socio-demographic Index (SDI) quintiles. Furthermore, this study employed a comprehensive analytical approach, including estimated annual percentage change (EAPC), decomposition analysis, and predictive modeling (Nordpred method).

RESULTS

From 1990 to 2021, the burden of PC in elderly exhibited a substantial rise, with incident cases, mortality cases, and DALYs all demonstrating significant increases. In 2021, the global age-standardized rates for incidence (ASIR), mortality (ASMR), and DALYs (ASDALYR) were 348.8 (95% uncertainty interval [UI]: 310.75 to 375.79), 177.93 (95% UI: 152.84 to 194.06) and 2513.84 (95% UI: 2170.81 to 2749.77) per 100,100, respectively. Geographically, the highest persistent burden was observed in High Income North America, Australasia, and high SDI region. Most regions were positively correlated with the SDI. The highest incidences of PC in elderly were in the 95 + age group. Decomposition analysis showed that the increase in burden indicators of PC in elderly globally and in the five SDI regions was mainly caused by population growth. Nordpred analysis predicts slight decline in ASIR, ASMR, and ASDALYR by 2046.

CONCLUSION

Our analysis unveils a considerable and relentlessly escalating global PC burden among the elderly, with striking geographical heterogeneity. These data underscore the pressing need for tailored public health strategies to mitigate the burgeoning impact of PC in the worldwide aging populace.