Epidemiology of prostate cancer in the Asia-Pacific region

Abstract

The purpose of this paper was to examine and compare available data on incidence, mortality and survival for countries in the Asia-Pacific region. Incidence data were obtained from GLOBOCAN 2008, other online data sources and individual cancer registries. Country-specific mortality statistics by individual year were sourced from the World Health Organization Statistical Information System Mortality Database. All incidence and mortality rates were directly age-standardised to the Segi World Standard population and joinpoint models were used to assess trends. Data on survival were obtained from country-specific published reports where available. Approximately 14% (122,000) of all prostate cancers diagnosed worldwide in 2008 were within the Asia-Pacific region (10 per 100,000 population), with three out of every four of these prostate cancer cases diagnosed in either Japan (32%), China (28%) or Australia (15%). There were also about 42,000 deaths due to prostate cancer in the Asia-Pacific region (3 per 100,000). For the nine countries with incidence trend data available, eight showed recent significant increases in prostate cancer incidence. In contrast, recent decreases in prostate cancer mortality have been reported for Australia, Japan and New Zealand, but mortality has increased in several other countries. The lack of population-based data across most of the countries in this region limits the ability of researchers to understand and report on the patterns and distribution of this important cancer. Governments and health planners typically require quantitative evidence as a motivation for change. Unless there is a widespread commitment to improve the collection and reporting of data on prostate cancer it is likely that the burden of prostate cancer will continue to increase. Enhancing knowledge transfer between countries where there are differentials in capacity, policy and experience may provide the necessary impetus and opportunity to overcome at least some of the existing barriers.

Keywords: Asia-Pacific; Incidence; Mortality; Prostate neoplasms; Prostate specific antigen.

Fig. 1

Age-specific incidence rates for prostate cancer, selected countries, 2003–2007. Data from: Australia, Australian Institute of Health and Welfare [9]; Hong Kong, Hong Kong Cancer Registry [10]; Japan, Center for Cancer Control and Information Services [11]; New Zealand, Ministry of Health [14]; South Korea, Korea Central Cancer Registry [15].

Fig. 2

Prostate cancer incidence rate trends for selected Asian-Pacific countries, 1980–2009. Y-axis is shown on a log scale. Rates were age-standardised to the Segi World Standard Population [19], and expressed per 100,000 males. Singapore data was only available for residents of Chinese ethnicity (who comprise the majority of the population but have slightly higher rates of prostate cancer than Malay or Indian residents). Data from: Australia, Australian Institute of Health and Welfare [9]; China, Shanghai Cancer Registry [13]; Hong Kong, Hong Kong Cancer Registry [10]; Japan, Center for Cancer Control and Information Services [11]; New Zealand, Ministry of Health [14]; Philippines, Manila Cancer Registry [13]; Singapore, National Cancer Centre Singapore [13]; South Korea, Korea Central Cancer Registry [15]; Thailand, Chaing Mai Cancer Registry [12,13].

Fig. 3

Prostate cancer mortality rate trends by age for selected Asian-Pacific countries, 1980–2010. Y-axis is shown on a log scale and expressed per 100,000 males. Rates were age-standardised to the Segi World Standard Population [19]. Data from World Health Organization Mortality Database [16]. Population data for the Philippines and Thailand was obtained from the United Nations [8].

Fig. 4

Prostate cancer incidence, mortality and mortality rate:incidence rate ratio (MR:IR) for Asian-Pacific countries, 2008. Rates were age-standardised to the Segi World Standard Population and expressed per 100,000 males [19]. MR:IR ratio categories were defined based on quintiles. Incidence categories were approximate quintiles, while mortality matched the incidence categories to enable comparison. Data from GLOBOCAN [7].