Table 2_Global, regional, and national prevalence of prostate cancer from 1990 to 2021: a trend and health inequality analyses.docx

BackgroundProstate cancer in men's health has become a significant driver of global disease burden, impacting aging populations worldwide. This study assesses its prevalence from 1990 to 2021 to reveal ongoing epidemiological trends and inform effective public health strategies.
MethodsProstate cancer prevalence estimates, including their 95% uncertainty intervals (UIs), were derived from the Global Burden of Disease (GBD) 2021 study. Then, temporal trends spanning the past 32 years were thoroughly analyzed using Joinpoint regression, with projections for the next 25 years made using the Bayesian Age-Period-Cohort (BAPC) model. Concurrently, disease trends were decomposed into components of population growth, aging, and epidemiological changes. Additionally, age-period-cohort (APC) models were also employed to explore the impact of age, time, and cohort effect on the relative risk of prostate cancer prevalence. And the cross-country inequalities in the prevalence of prostate cancer burden were meticulously evaluated through the Socio-Demographic Index (SDI), revealing significant disparities across socio-economic strata.
ResultIn 2021, over 10 million prostate cancer cases were recorded worldwide—a 188.85% increase from 3.6 million in 1990. The age-standardized prevalence rate (ASPR) rose at an estimated annual percentage change of 0.64% (95% UI: 0.47%−0.82%); Joinpoint regression revealed a steady increase in case numbers over 32 years, while the ASPR peaked and then slightly declined. Decomposition analysis showed population growth as the main driver (65.62%), with epidemiological changes and aging accounting for 17.97 and 16.41%, respectively. APC modeling indicated the highest relative risk around age 75—nearly 10 times that of the general population (RR: 9.99; 95% CI: 9.97–10.01). Projections through 2046 forecast a continued rise in both total cases and ASPR.
ConclusionsAs a major health concern among older adult men, the global prevalence of prostate cancer has risen steadily since 1990, with population growth identified as the primary driver. Moreover, SDI-related disparities across 204 countries and territories have widened over time. Finally, the APC model forecasts a continuous increase in prevalence over the next 25 years, underscoring the growing disease burden and the urgent need for more targeted and effective management strategies.

背景：前列腺癌已成为全球男性健康相关疾病负担的核心驱动因素，对全球老龄化人口造成了显著冲击。本研究针对1990年至2021年的前列腺癌患病率展开系统评估，旨在揭示其持续演变的流行病学趋势，为制定高效的公共卫生干预策略提供科学依据。方法：前列腺癌患病率估计值（含95%不确定区间（UIs））源自《全球疾病负担研究2021》（Global Burden of Disease 2021, GBD 2021）。随后，采用连接点回归（Joinpoint regression）对过去32年的时间趋势进行全面剖析，并通过贝叶斯年龄-时期-队列（BAPC）模型对未来25年的患病率进行预测。同时，将疾病流行趋势分解为人口增长、人口老龄化及流行病学特征变化三个核心组分。此外，本研究还借助年龄-时期-队列（APC）模型，探究年龄、时期及队列效应对前列腺癌患病率相对风险的影响机制。通过社会人口指数（Socio-Demographic Index, SDI），对前列腺癌疾病负担患病率的跨国不平等性开展精细化评估，揭示不同社会经济阶层间存在的显著差异。结果：2021年，全球前列腺癌确诊病例数超过1000万，较1990年的360万增长188.85%。年龄标化患病率（ASPR）的估计年均变化率为0.64%（95%不确定区间：0.47%−0.82%）；连接点回归分析显示，32年间总病例数持续稳步上升，而年龄标化患病率则先达峰值后略有回落。分解分析结果表明，人口增长是患病率上升的主要驱动因素（贡献占比65.62%），流行病学特征变化与人口老龄化的贡献分别为17.97%和16.41%。年龄-时期-队列（APC）模型显示，75岁左右人群的相对风险最高，约为普通人群的10倍（相对风险RR: 9.99；95%置信区间CI: 9.97–10.01）。至2046年的预测结果显示，总病例数与年龄标化患病率均将持续攀升。结论：作为老年男性群体的主要健康威胁之一，全球前列腺癌患病率自1990年以来持续走高，人口增长被认定为首要驱动因素。此外，全球204个国家与地区间基于社会人口指数的健康差异随时间不断扩大。最后，年龄-时期-队列模型预测未来25年患病率将持续上升，这凸显了前列腺癌疾病负担的日益加重，以及制定更具针对性、更有效的临床与公共卫生管理策略的迫切需求。