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Abstract

Volume 13, Issue 4 (July 2011) 13, 574–578; 10.1038/aja.2010.126

Prostate cancer: an emerging threat to the health of aging men in Asia

Ling Zhang1, Bao-Xue Yang1, Hai-Tao Zhang2, Jin-Guo Wang1,3, Hong-Liang Wang1,3 and Xue-Jian Zhao1,3

1 Prostate Diseases Prevention and Treatment Research Centre, Jilin University, Changchun 130021, China
2 Department of Pathology and Laboratory Medicine, Tulane University School of Medicine, New Orleans, LA 70131, USA
3 Department of Andrology, First Hospital of Jilin University, Changchun 130021, China

Correspondence: Professor HL Wang, (whl1228@126.com)

Abstract

The aim of this study was to determine and examine the possible reasons for the difference in prostate cancer incidence between Asian men and North American men by literature review. Data regarding cancer incidence and mortality were obtained from the database of the International Agency for Research on Cancer (IARC). A literature review was conducted by studying related articles published in peer-reviewed journals such as the The New England Journal of Medicine, Journal of Clinical Oncology, A Cancer Journal for Clinicians and Asian Journal of Andrology. To evaluate the early diagnosis and survival rates, the mortality-to-incidence rate ratio (MR/IR) was calculated from the IARC data. By comparing prostate cancer data between Asian men and North American men, we found that differences in the incidence rate and MR/IR could be attributed largely to a lack of annual prostate cancer screening with serum prostate-specific antigen (PSA) in most Asian countries. It is likely that PSA screening also contributes significantly to the differences in prostate cancer mortality rates. Prostate cancer has the highest incidence rate among five common malignancies in Asian Americans. However, the MR/IR ratio of prostate cancer is the lowest among cancers. These data seem to further support the usefulness of PSA screening, even though the percentage of low risk cancers is greater in prostate cancer than in other cancers. The low incidence rate of prostate cancer does not reflect the actual statistics of this disease in Asia. The data from limited institutions in many Asian countries seem to bias the true incidence and mortality rates. To improve this situation, incorporating PSA screening for prostate cancer, as well as constructing a nationwide cancer registration system, will be helpful.

Keywords: Incidence; mortality; prostate cancer; prostate-specific antigen

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