Global Trends and Prostate Cancer: A Review of Incidence, Detection, and Mortality as Influenced by Race, Ethnicity, and Geographic Location

Abstract

Although research has reported that prostate cancer (PCa) incidence and mortality rates are among the highest for African Americans, the data is inconclusive regarding PCa rates in native African men, Black men residing in other countries, and men in Asia, Europe, and the Americas. Data reveals that prostate-specific antigen (PSA) testing and disease incidence have risen significantly in developing and Asian countries, and PCa has become one of the leading male cancers in many of those nations. The objective of this study was to review published peer-reviewed studies that address PCa in different regions of the world to get a better understanding of how PCa incidence, prevalence, detection, and mortality are influenced by race, ethnicity, and geography. A secondary goal was to compare PCa data from various world regions to contextualize how disproportionate the incidence and mortality rates are among men from the African diaspora versus men of European, Hispanic, and Asian descent, as well as to highlight the need for more robust screening and treatment guidelines in developing countries. There are differences in incidence and mortality rates between men of African, Asian, Hispanic, and European ancestry, confirming the involvement of genetic factors. However, differences between men of the same race and ethnicity who live in different countries suggest that environmental factors may also be implicated. Availability and access to diagnostic and health-care services as well as recommendations regarding PCa testing vary from country to country and contribute to the variability in incidence and mortality rates.

Keywords: PSA testing; behavioral issues; cultural disparity; development and aging; general health and wellness; genetics; men of color; psychosocial and cultural issues; risk factors; special populations.

Figure 1.

Prostate cancer incidence and mortality rates by geographical area. From “Global Cancer Statistics, 2012,” by L. A. Torre, F. Bray, R. Siegel, J. Ferlay, J. Lortet-Tievlent, and A. J. Jemal, 2015, CA: A Cancer Journal for Clinicians, 65, p. 87. Copyright 2015 by the American Cancer Society. Reprinted with permission.

Figure 2.

Trends in the percent of U.S. men >50 years who received ⩾one PSA test in prior year and the first PSA test in the prior year. PSA = prostate-specific antigen. Adapted from “Annual Report to the Nation on the Status of Cancer, Part II: Recent Changes in Prostate Cancer Trends and Disease Characteristics,” by S. Negoita, E. J. Feuer, A. Mariotto, K. A. Cronin, V. I. Petkov, S. K. Hussey, … R. L. Sherman, 2018, Cancer, 124, p. 2801. Copyright 2018 by the American Cancer Society.

Figure 3.

Prostate cancer incidence and death rates in America by race and ethnicity, 2008–2012. Rates are per 100,000 population and age adjusted to the 2000 U.S. standard population. Non-White and non-Black race categories are not mutually exclusive of Hispanic origin. Adapted from “Cancer Statistics, 2016,” R. L. Siegel, K. D. Miller, and A. Jemal, 2016, CA: A Cancer Journal for Clinicians, 66, p. 7. Copyright 2015 by the American Cancer Society.

Figure 4.

AAPC in incidence and mortality rates for the past 10 years of available SEER data. AAPC = average annual percent change; SEER = Surveillance Epidemiology and End Results. Reprinted from Center et al., 2012.

Figure 5.

Incidence and mortality rates (per 100,000) in different Asian regions in 2012. Data source: GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC Cancer Base No. 11. Adapted from Chen et al., 2014, “Prostate Cancer in Asia: A Collaborative Report.”