Epidemiology of prostate cancer in Asian countries
Takahiro Kimura and Shin Egawa
Department of Urology, Jikei University School of Medicine, Tokyo, Japan
Abbreviations & Acronyms
CI = conﬁdence interval
NA = not available
PCa = prostate cancer
UAA = Urological
Association of Asia
WHO = World Health
Kimura M.D., Ph.D.,
Department of Urology, Jikei
University School of Medicine,
Minato-ku, Tokyo 105-8461,
Received 13 January 2018;
accepted 19 March 2018.
Online publication 8 May 2018
Abstract: The incidence of prostate cancer has been increasing worldwide in recent
years. The GLOBOCAN project showed that prostate cancer was the second most
frequently diagnosed cancer and the ﬁfth leading cause of cancer mortality among men
worldwide in 2012. This trend has been growing even in Asian countries, where the
incidence had previously been low. However, the accuracy of data about incidence and
mortality as a result of prostate cancer in some Asian countries is limited. The cause of
this increasing trend is multifactorial. One possible explanation is changes in lifestyles
due to more Westernized diets. The incidence is also statistically biased by the wide
implementation of early detection systems and the accuracy of national cancer
registration systems, which are still immature in most Asian countries. Mortality rate
decreases in Australia, New Zealand and Japan since the 1990s are possibly due to the
improvements in treatment and/or early detection efforts employed. However, this rate
is increasing in the majority of other Asian countries. Studies of latent and incidental
prostate cancer provide less biased information. The prevalence of latent and incidental
prostate cancer in contemporary Japan and Korea is similar to those in Western
countries, suggesting the inﬂuence of lifestyle changes on carcinogenesis. Many studies
reported evidence of both congenital and acquired risk factors for carcinogenesis of
prostate cancer. Recent changes in the acquired risk factors might be associated with
the increasing occurrence of prostate cancer in Asian countries. This trend could
continue, especially in developing Asian countries.
Asia, epidemiology, latent cancer, prostate cancer, risk factor.
PCa is the most prevalent male malignancy in many regions of the world. However, remark-
able racial and ethnic differences in the incidence have been reported, ranging from 4.4 per
100 000 to 118.2 per 100 000 persons in India and the USA, respectively. Additionally, it
represents the second most common cause of cancer-related mortality in the USA and Eur-
The incidence of PCa has been increasing worldwide in recent years. This trend has
been growing even in Asian countries, particularly in northeast Asian countries. In Japan,
PCa surpassed stomach and lung cancer as the leading type of cancer among men in 2015;
previously, the incidence of PCa was relatively low.
The cause of this increase is compli-
cated and might be multifactorial, with one possible explanation being changes in lifestyles
due to more Westernized diets.
The incidence of PCa is also thought to be statistically biased due to the implementation of
early detection systems, such as PSA screening programs, and the accuracy of national cancer
registration systems. Mature PSA screening programs and national cancer registration systems
are not yet available in many Asian countries. Recent studies of latent PCa have suggested
that the prevalence of latent PCa has increased in most Asian countries.
In the present literature review, we aimed to determine the trend in the incidence and mor-
tality of PCa in Asian countries, especially in associate and afﬁliate countries of the UAA.
Additionally, we describe the risk factors associated with PCa and the genetic differences
Incidence and mortality
The incidence of PCa has been increasing since the early 1990s, especially in developed
countries, possibly because of the implementation of PSA testing.
© 2018 The Japanese Urological Association
International Journal of Urology (2018) 25, 524--531 doi: 10.1111/iju.13593