Prostate cancer is the second most frequent cancer diagnosis made in men and the fifth leading cause of death worldwide. Prostate cancer may be asymptomatic at the early stage and often has an indolent course that may require only active surveillance. Based on GLOBOCAN 2018 estimates, 1,276,106 new cases of prostate cancer were reported worldwide in 2018, with higher prevalence in the developed countries. Differences in the incidence rates worldwide reflect differences in the use of diagnostic testing. Prostate cancer incidence and mortality rates are strongly related to the age with the highest incidence being seen in elderly men (> 65 years of age). African-American men have the highest incidence rates and more aggressive type of prostate cancer compared to White men. There is no evidence yet on how to prevent prostate cancer; however, it is possible to lower the risk by limiting high-fat foods, increasing the intake of vegetables and fruits and performing more exercise. Screening is highly recommended at age 45 for men with familial history and African-American men. Up-to-date statistics on prostate cancer occurrence and outcomes along with a better understanding of the etiology and causative risk factors are essential for the primary prevention of this disease.
Figure 1
Region-specific incidence and mortality. Age-standardized rates for prostate cancer in 2020. Rates are shown in descending order of the world (W). Age-standardized incidence rate, and the highest national age-standardized rates for incidence and mortality are superimposed. Source: GLOBOCAN 2020. https://gco.iarc.fr [Accessed on 06 April 2021].
Prostate cancer in Brazil and Latin America: epidemiology and screening
Prostate cancer is the main cancer in Brazilian men, excluding non-melanoma skin cancer. In 2012, there were 60.180 new cases, corresponding to 62 new cases/100.000 men. The most developed regions of the country registered the highest number of cases: 78 new cases/100.000 men in Southeast [40] (Figure-2). The increasing incidence of prostate cancer has been correlated to the increasing life expectancy of Brazilian population, to better assessment of medical data, to higher availability of diagnostic methods and overdiagnosis due to screening policies. There are conflicting data regarding prevalence per race: some studies show higher prevalence in African-american population and others don't demonstrate significant difference.
Figure 2
Crude rates of incidence of prostate cancer, per 100.000 men, estimated for the year 2014, according to Federation Units.
In relation to mortality due to cancer in Brazilian men, prostate cancer is the second main cause of death, following lung cancer. In 2012, there were 13.354 deaths due to prostate tumor in Brazil, corresponding to 13% of all deaths due to cancer in men. Among these, 88% occurred in men over 65 years old (4). Figure-3 presents the distribution of prostate cancer mortality according to Brazilian regions in 2012.
Figure 3
Mortality rates of prostate cancer, per 100.000 men, adjusted to World population. Brazil, 2012.
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Mortality in America is still high, with 80.000 new cases per year, being the second most frequent cause of death due to cancer in men. These numbers are higher in Central America, followed by South and North America. There are higher rates of incidence/mortality in countries more developed and with higher Gross National Product (Figure-6).
Figure 6
Incidence/mortality ratio of prostate cancer, compared to gnp per capita per country, 2012.
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