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Prostate cancer in Asian men

Nature Reviews Urology volume 11, pages 197–212 (2014)Cite this article

Subjects

Key Points

  • The reported incidence of prostate cancer in native Asians is one-third lower than in Asian–American populations, probably primarily due to lower exposure to PSA screening in Asian countries

  • Prostate cancer incidence also differs among native Asians, possibly reflecting variable accessibility to PSA testing and urology clinics as age-stratified median PSA levels are almost identical across several Asian countries

  • A trend toward increasing incidence of prostate cancer demonstrated by epidemiological research in Asian countries might be due to gradual implementation of PSA screening and improved biopsy techniques in these regions

  • Although the incidence of prostate cancer worldwide varies, the risk of developing prostate cancer might be almost equivalent among populations that have the same baseline levels of PSA

  • Appropriate screening strategies and therapies for prostate cancer in Asian countries probably differ from those in Western countries: in Asia, prostate cancers generally demonstrate high likelihood of advanced clinical stage

  • Thus, the prostate cancer screening and treatment protocols recommended for use in Asia should be individualized based on the epidemiological features and socioeconomic status of each country

Abstract

Prostate cancer incidence and mortality in most native Asian populations have gradually increased, but are around one-third lower than in corresponding Asian–American cohorts, which are themselves lower than the rates observed in other American cohorts. Although genetic and environmental factors, particularly a Western diet, could partially explain these differences, lower exposure to PSA screening in Asian individuals might be a major contributing factor. Genetic features and diet are, however, unlikely to differ substantially within the same region of Asia, and age-stratified PSA levels in men from various Asian countries are almost identical; therefore, variation in the epidemiology of prostate cancer among native Asian populations might be attributable to differences in access to PSA testing, urology clinics, and available therapies. Conversely, the proportion of patients with metastatic prostate cancer is substantially higher even in the more developed Asian countries than in migratory Asian populations residing in Western countries and in Westerners. Consequently, the most appropriate approaches to the management of prostate cancer in Asian countries probably also differ, and therefore individualized prostate cancer screening and treatment strategies based on the epidemiological features and socioeconomic status of each country are needed.

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Figure 1: Established data regarding prostate cancer in Asian countries.
Figure 2: Changes in prostate cancer incidence and mortality over time in Asian countries.
Figure 3: Prostate cancer mortality in Asian regions and countries.
Figure 4: Mortality rate to incidence rate ratio of prostate cancer in Asian and Asian–American populations.

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  1. Department of Urology, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, 371-8511, Gunma, Japan

    Kazuto Ito

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The three most frequent male cancers and prostate cancer incidence in Asian countries (DOC 119 kb)

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Ito, K. Prostate cancer in Asian men. Nat Rev Urol 11, 197–212 (2014). https://doi.org/10.1038/nrurol.2014.42

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