Prostate cancer worldwide: updated epidemiology, disparities, and screening implications
Abstract Background Prostate cancer epidemiology is evolving because of three simultaneous factors: a rising global burden, population aging, and renewed debate about how early detection can reduce advanced disease without returning to non-risk-adapted PSA testing. This Review provides an updated overview of prostate cancer incidence, mortality, prevalence, risk factors, disparities, and screening implications. Methods We synthesized recent systematic reviews, meta-analyses, randomized screening trials, and population-based registry data, supplemented by landmark historical studies. Results Current trends cannot be interpreted without accounting for screening policy, diagnostic intensity, access to MRI and biomarkers, inherited susceptibility, and health-system capacity. Age, family history, ancestry, and germline risk remain the strongest determinants. Most modifiable exposures are weaker and inconsistent, and are better framed within cardiometabolic health and survivorship care. Organized, risk-adapted pathways integrating PSA, MRI, biomarkers, and baseline risk may better preserve early-detection benefits while reducing overdiagnosis and inequity. Conclusions Progress will depend on preventing metastatic disease, minimizing overtreatment, and implementing modern diagnostics equitably.
Authors
- Alexandre R. Zlotta (ORCID: https://orcid.org/0000-0003-2315-5809)
- Frederico Ferronha
- Spyridon P. Basourakos (ORCID: https://orcid.org/0000-0002-7458-4593)
- Zeyad R. Schwen (ORCID: https://orcid.org/0000-0001-7334-3600)
- Giorgio Gandaglia (ORCID: https://orcid.org/0000-0002-5052-721X)
- Jonathan Evan Shoag (ORCID: https://orcid.org/0000-0002-3119-9986)
- Andrea Cosenza (ORCID: https://orcid.org/0009-0000-5987-4659)
- Riccardo Autorino B (ORCID: https://orcid.org/0000-0001-7045-7725)
- Firas Abdollah (ORCID: https://orcid.org/0000-0003-1298-8231)
- Jihad H Kaouk (ORCID: https://orcid.org/0000-0002-7127-6069)
- Jane Nguyen (ORCID: https://orcid.org/0000-0002-1653-4942)
- Quoc‐Dien Trinh (ORCID: https://orcid.org/0000-0003-3857-9276)
- Christopher Wallis (ORCID: https://orcid.org/0000-0003-0918-6449)
- Sigrid Carlsson (ORCID: https://orcid.org/0000-0003-3553-5710)
- Rui Miguel Marques Bernardino (ORCID: https://orcid.org/0000-0001-8076-4550)
- David‐Dan Nguyen (ORCID: https://orcid.org/0000-0001-5570-8792)
- Cosimo De Nunzio (ORCID: https://orcid.org/0000-0002-2190-512X)
- Salim Younis (ORCID: https://orcid.org/0009-0004-6596-9100)
- Karim Daher (ORCID: https://orcid.org/0009-0006-5426-9867)
- Carlo La Vecchia (ORCID: https://orcid.org/0000-0003-1441-897X)
- Neil E. Fleshner
- Mohammad El Hussein (ORCID: https://orcid.org/0000-0003-4152-9165)
- Mohamad Watfa (ORCID: https://orcid.org/0009-0003-7744-6190)
- Abdulrahman Muataz Al-Bayati (ORCID: https://orcid.org/0000-0002-2579-0534)
- Christopher J. Weight
- Nicolas A. Soputro
- Rebecca Campbell
Institutions
- Cleveland Clinic (US)
- Henry Ford Health System (US)
- University of Pittsburgh (US)
- German Cancer Research Center (DE)
- University of Toronto (CA)
- Lund University (SE)
- University of Milan (IT)
- Henry Ford Hospital (US)
- University Hospitals Cleveland Medical Center (US)
- Administração Regional de Saúde de Lisboa e Vale do Tejo (PT)
- Azienda Ospedaliera Sant'Andrea (IT)
- IRCCS Ospedale San Raffaele (IT)
- Glickman Urological Institute (US)
- Case Western Reserve University (US)
Publication Details
- Journal
- Prostate Cancer and Prostatic Diseases
- Published
- 2026-10-27
- DOI
- https://doi.org/10.1038/s41391-026-01167-8
- Primary Topic
- Prostate Cancer Diagnosis and Treatment
- Type
- article
- Field-Weighted Citation Impact
- 0.00