Prostate cancer burden and attributable risk factors in East Asia from 1990 to 2021: a systematic analysis

Prostate cancer is a significant health concern in East Asia, where distinctive characteristics of disease presentation and outcomes warrant focused epidemiological investigation. This study evaluated the current status, future trends and risk factors across six East Asian regions. Mortality, incidence, Disability-Adjusted Life-Years (DALYs), and age-standardized rates were estimated using data from the Global Burden of Disease Study 2021. Join point, an age-period-cohort model and decomposition analyses were applied to reflect epidemiological trends. The Autoregressive Integrated Moving Average (ARIMA) model was used to predict the burden of prostate cancer 2022-2050. Taiwan had the highest Age-Standardized Mortality Rate (ASMR: 10.83 [95% uncertainty interval [UI]: 9.48-12.18]), Age-Standardized Incidence Rate (ASIR: 37.68 [95% UI: 32.54-43.34]), and DALY rate (ASDR: 192.07 [95% UI: 170.35-214.13]) in 2021. Mortality increased with age across all regions, while the cohort effect on mortality remained stable. The effects of age, period and cohort on mortality and incidence and the percentage of aging, population and epidemiological changes in the total trend differed across regions. ARIMA projections predicted a "U"-shaped ASMR trends in Japan. The Democratic People's Republic of Korea had the highest DALYs attributable to low in milk and calcium intake, whereas smoking-related ASDR were highest in Taiwan. The prostate cancer burden in East Asia remains substantial, particularly among older populations. Although overall trends appear more favourable than global averages, several regions face concerning future prospects.