Global prostate and testicular cancer rates are rising, but mortality is falling

Global prostate and testicular cancer rates are rising, but mortality is falling

A global study of prostate and testicular cancer shows increasing prevalence and incidence but decreasing mortality, highlighting the need for targeted health strategies.

Prostate and testicular cancers are growing concerns about men's health worldwide. A recent study by Chinese researchers published in the journal Scientific Reports analyzed global trends in male cancers from 1990 to 2021 and predicted patterns through 2040. With aging, treatment and policy design to reduce the burden of male cancers.

Male cancers

Regional differences in prostate cancer mortality - Sub-Saharan Africa has the highest mortality rates, while high-income North America sees the highest prevalence but lower mortality rates due to better access to healthcare.

Male cancers such as prostate and testicular cancers contribute significantly to global cancer-related morbidity and mortality in men. Prostate cancer is one of the most common cancers in men, often diagnosed late due to mild or lack of early symptoms. It can lead to serious complications such as bone metastases, paralysis and kidney failure.

Testicular cancer, although less common, disproportionately affects younger men and can affect fertility and mental health. The study also found that psychological distress, including anxiety, depression and lowered self-esteem, is a significant but often overlooked consequence of male cancer diagnoses. Furthermore, despite medical advances, differences in cancer burden persist between regions and are influenced by socioeconomic factors.

Statistics show that male cancers have not been studied as extensively as female cancers. Furthermore, existing data often focus on either prostate cancer or testicular cancer separately or are outdated. Understanding the global trends in prevalence, incidence, mortality and disability associated with cancer is essential for optimizing healthcare strategies.

The current study

The unexpected burden of testicular cancer in middle-aged men - although most common in younger men (25-34), the study found a peak in secondary mortality after age 55, suggesting better long-term follow-up care.

The present study aimed to address this knowledge gap by analyzing the recent 2021 Global Burden of Disease (GBD) data to provide a comprehensive overview of male cancers worldwide. The study used data from the GBD 2021 database and analyzed from 1990 to 2021 in 204 countries and 21 global regions.

The study categorized countries using the sociodemographic index (SDI), which accounts for income, education and fertility rates. The SDI classification allowed researchers to compare cancer burdens in different economic and social contexts. They also used various statistical models to examine the correlations between SDI and cancer burden.

To identify drivers of changes in cancer cases over time, the team used specific algebraic methods to isolate the contributions of aging, population growth and epidemiological changes to the observed trends. Numerous other statistical models have also been applied to predict future trends through 2040, including estimates for future prevalence, incidence, mortality, and DALYs of prostate cancer and testicular cancer.

The study focused solely on quantitative epidemiological data and not on clinical treatment outcomes. However, it has been recognized that late-stage prostate cancer can lead to serious complications such as spinal metastases and kidney failure, which influence healthcare burdens. By systematically assessing trends and risk factors, the researchers aimed to provide insights for policymakers and health professionals to develop targeted interventions to reduce the global burden of male cancer.

Key Findings

Future projections show diverging trends - by 2040, the prevalence of prostate cancer is expected to increase by 2.3%, while the prevalence of testicular cancer is expected to grow more significantly, particularly in regions with high SDI.

The study found that male cancers have shown a consistent upward trend in prevalence and incidence, while mortality and DALys associated with male cancers have decreased. In 2021, the global age-standardized prostate cancer prevalence, incidence, mortality and DALY rates were 260.05, 34.05, 12.63 and 217.83 per 100,000 people, respectively. For testicular cancer, these rates were lower at 16.59, 2.24, 0.29, and 13.83, respectively.

Importantly, the study identified notable regional differences. High-SDI regions such as North America and Western Europe had the highest prevalence and incidence rates, while low-SDI regions such as sub-Saharan Africa had the highest mortality and Daly rates due to differences in healthcare access.

The age analysis found that the burden of prostate cancer is highest in men over 70, while testicular cancer mainly affects those aged 25 to 34. In addition, testicular cancer before age 45 has a greater disease burden than prostate cancer, but after 45, prostate cancer dominates male cancer statistics. High-SDI regions had the highest prevalence and incidence, while low-SDI regions had the highest mortality and Daly rates.

The study also found that the long-term epidemiological trends of prostate cancer fluctuated, with a slowing in prevalence and incidence after 1996, a decline after 2008, and a stabilization after 2013. Affects detection rates over time.

While aging populations were identified as the main driver of prostate cancer cases, researchers found that epidemiological changes played a larger role in driving testicular cancer trends. Population growth was identified as a key factor affecting mortality rates.

Smoking and diets high in calcium have been identified as risk factors for prostate cancer. However, the study highlighted that aging remains the dominant factor affecting the prevalence and incidence of prostate cancer.

Furthermore, projections for 2040 predicted continued increases in prevalence and incidence but declines in mortality and DALYs. For prostate cancer, prevalence is expected to increase to 266.23 per 100,000, while mortality is expected to decrease to 9.11 per 100,000. In the meantime, the burden of testicular cancer is expected to remain stable with only minor changes in incidence and mortality.

The researchers acknowledged that the study had some important limitations, including potential biases in GBD data collection and the exclusion of genetic or environmental variables. They believe future research should integrate molecular and clinical data for a more comprehensive understanding of male cancer trends.

Conclusions

In summary, the study highlighted the growing burden of male cancer and emphasized the need for targeted prevention and health strategies. Although the incidence and prevalence of male cancers are increasing, improved treatment methods are also reducing mortality and DALys.

Future policymakers need to focus on high-risk groups, particularly older men for prostate cancer and younger men for testicular cancer. Strengthening screening programs and addressing lifestyle risk factors will also be key to mitigating the future impact of these diseases. Additionally, regional disparities in health care access and cancer mortality need to be addressed to ensure equitable outcomes across diverse socioeconomic settings.

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