Changing demography of prostate cancer in Asia
Introduction
Prostate cancer remains one of the most common cancers afflicting men today. It is the third most common cancer in the world and the most frequently diagnosed male cancer in the United States of America (USA), with a world age-standardised rate of 104 per 100,000 [1]. Prostate cancer rates are highest in Western countries and lowest in Asian countries. With ageing populations and increasing use of prostate-specific antigen (PSA) screening, the incidence of prostate cancer in the high-risk countries has risen sharply in the past decade [2], [3], [4]. In Asia, however, the incidence of prostate cancer is significantly lower and it often plays second fiddle to lung, stomach and colon cancer. It is thus revealing that recent data from Asia have shown a general trend towards increasing incidence of prostate cancer, with some low-risk regions, such as Japan and Singapore, reporting a more rapid increase than some high-risk countries [5]. Understanding the genetic and environmental basis for this difference and the changing demographics of Asian prostate cancer has emerged as an important field of study. Several epidemiological studies involving multi-disciplinary and multi-centre collaboration to investigate suspected environmental factors for prostate cancer are ongoing. This review critically examines available data regarding changing epidemiological trends in Asian prostate cancer and discusses the possible reasons behind these trends.
Section snippets
Material and methods
Age-specific and age-standardised (world) incidence rates per 100,000 man-years for prostate cancer over a 20-year period (1978–1997) in Asian countries were retrieved from the four volumes (V–VIII) of Cancer Incidence in Five Continents, published by the International Agency for Research on Cancer (IARC), covering the periods 1978–1982, 1983–1987, 1988–1992 and 1993–1997 [6], [7], [8], [9]. These data were derived from contributions from various cancer registries over the years. The criteria
Changing demographics – is it for real?
National and regional cancer registries are pivotal in providing an in-depth look at the epidemiological map of prostate cancer across Asia. The number of cases of prostate cancer reported in the listed Asian countries ranged from 24–558 during 1978–1982 to 146–1654 during 1993–1997. Age-standardised incidence rates per 100,000 man-years for prostate cancer from Asian countries over a 20-year period from 1978 to 1997 confirmed that the incidence of prostate cancer has risen 5–118% in most of
Conclusion
Prostate cancer incidence and mortality rates have shown a rising trend over the last two decades but still remain lower in Asia than in Western countries. The difference may be the result of genetic factors and certain protective lifestyle, dietary or environmental factors. However, with globalisation and gradual Westernisation, many Asian countries may be losing their protective cultural factors and acquiring high-risk ones. A better understanding of how these factors interact to cause
Conflict of interest statement
None declared.
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