Skip to main content

Advertisement

SpringerLink
Log in

National economic and development indicators and international variation in prostate cancer incidence and mortality: an ecological analysis

  • Topic Paper
  • Published:
World Journal of Urology Aims and scope Submit manuscript

Abstract

Background

Macroeconomic indicators are likely associated with prostate cancer (PCa) incidence and mortality globally, but have rarely been assessed.

Methods

Data on PCa incidence in 2003–2007 for 49 countries with either nationwide cancer registry or at least two regional registries were obtained from Cancer Incidence in Five Continents Vol X and national PCa mortality for 2012 from GLOBOCAN 2012. We compared PCa incidence and mortality rates with various population-level indicators of health, economy and development in 2000. Poisson and linear regression methods were used to quantify the associations.

Results

PCa incidence varied more than 15-fold, being highest in high-income countries. PCa mortality exhibited less variation, with higher rates in many low- and middle-income countries. Healthcare expenditure (rate ratio, RR 1.46, 95 % CI 1.45–1.47) and population growth (RR 1.15, 95 % CI 1.14–1.16), as well as computer and mobile phone density, were associated with a higher PCa incidence, while gross domestic product, GDP (RR 0.94, 95 % CI 0.93–0.95) and overall mortality (RR 0.72, 95 % CI 0.71–0.73) were associated with a low incidence. GDP (RR 0.55, 95 % CI 0.46–0.66) was also associated with a low PCa mortality, while life expectancy (RR 3.93, 95 % CI 3.22–4.79) and healthcare expenditure (RR 1.20, 95 % CI 1.09–1.32) were associated with an elevated mortality.

Conclusions

Our results show that healthcare expenditure and, thus, the availability of medical resources are an important contributor to the patterns of international variation in PCa incidence. This suggests that there is an iatrogenic component in the current global epidemic of PCa. On the other hand, higher healthcare expenditure is associated with lower PCa death rates.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J et al (2013) Cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 49:1374–1403

    Article  CAS  PubMed  Google Scholar 

  2. Ferlay J, Soerjomataram I, Dikshit R et al (2015) Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBCAN 2012. Int J Cancer 136:E359–E386

    Article  CAS  PubMed  Google Scholar 

  3. Bray F, Lortet-Tieulent J, Ferlay J, Forman D, Auvinen A (2010) Prostate cancer incidence and mortality trends in 37 European countries: an overview. Eur J Cancer 46:3040–3052

    Article  CAS  PubMed  Google Scholar 

  4. Baade PD, Youlden DR, Krnjacki LJ (2009) International epidemiology of prostate cancer: geographical distribution and secular trends. Mol Nutr Food Res 53:171–184

    Article  CAS  PubMed  Google Scholar 

  5. Platz EA, Giovannucci E (2006) Prostate cancer. In: Schottenfeld D, Fraumeni JF (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 1128–1150

    Chapter  Google Scholar 

  6. Parkin DM, Bray F (2006) International patterns of cancer incidence and mortality. In: Schottenfeld D, Fraumeni JF Jr (eds) Cancer epidemiology and prevention. Oxford University Press, New York, pp 101–138

    Chapter  Google Scholar 

  7. Bansal D, Undela K, D’Cruz S, Schifano F (2012) Statin use and risk of prostate cancer: a meta-analysis of observational studies. PLoS ONE 7:e46691

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Stopsack KH, Ziehr DR, Rider JR, Giovannucci EL (2016) Metformin and prostate cancer mortality: a meta-analysis. Cancer Causes Control 2:105–113

    Article  Google Scholar 

  9. Thompson IM, Goodman PJ, Tangen CM et al (2003) The influence of finasteride on the development of prostate cancer. N Engl J Med 349:215–224

    Article  CAS  PubMed  Google Scholar 

  10. Andriole GJ, Bostwick DG, Brawley OW et al (2010) Effect of dutasteride on the risk of prostate cancer. N Engl J Med 362:1192–1202

    Article  CAS  PubMed  Google Scholar 

  11. Liu Y, Chen JQ, Xie L et al (2014) Effect of aspirin and other non-steroidal anti-inflammatory drugs on prostate cancer incidence and mortality: a systematic review and meta-analysis. BMC Med 12:55

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Forman D, Bray F, Brewster DH, Gombe Mbalawa C, Kohler B, Piñeros M, Steliarova-Foucher E, Swaminathan R Ferlay J (eds) (2013) Cancer incidence in five continents, vol. X (electronic version). International Agency for Research on Cancer, Lyon. http://ci5.iarc.fr. Accessed 10 Dec 2014

  13. Jacoby WG (2005) Regression III: advanced methods. http://polisci.msu.edu/jacoby/icpsr/regress3/

  14. Hayes RB, Ziegler RG, Gridley G et al (1999) Dietary factors and risks for prostate cancer among blacks and whites in the United States. Cancer Epidemiol Biomarkers Prev 8:25–34

    CAS  PubMed  Google Scholar 

  15. Whittemore AS, Kolonel LN, Wu AH et al (1995) Prostate cancer in relation to diet, physical activity, and body size in blacks, whites, and Asians in the United States and Canada. J Natl Cancer Inst 87:652–661

    Article  CAS  PubMed  Google Scholar 

  16. Potosky AL, Miller BA, Albertsen PC et al (1995) The role of increasing detection in the rising incidence of prostate cancer. JAMA 273:548–552

    Article  CAS  PubMed  Google Scholar 

  17. Jacobsen SJ, Girman CJ, Guess HA, Oesterling JE, Lieber MM (1995) New diagnostic and treatment guidelines for benign prostatic hyperplasia: potential impact in the United States. Arch Intern Med 155:477–481

    Article  CAS  PubMed  Google Scholar 

  18. Sennfalt K, Carlsson P, Varenhorst E (2006) Diffusion and economic consequences of health technologies in prostate cancer care in Sweden, 1991–2002. Eur Urol 49:1028–1034

    Article  PubMed  Google Scholar 

  19. Kvåle R, Auvinen A, Adami HO et al (2007) Interpreting trends in prostate cancer incidence and mortality in the five Nordic countries. J Natl Cancer Inst 99:1881–1887

    Article  PubMed  Google Scholar 

  20. Bratt O, Berglund A, Adolfsson J, Johansson JE, Törnblom M, Stattin P (2010) Prostate cancer diagnosed after PSA testing of men without clinical signs of the disease—a population-based study from the National Prostate Cancer Register. Scand J Urol Nephrol 44:384–390

    Article  PubMed  Google Scholar 

  21. Smailyte G, Aleknaviciene B (2012) Incidence of prostate cancer in Lithuania after introduction of Early Prostate Cancer Detection Programme. Public Health 126:1075–1077

    Article  CAS  PubMed  Google Scholar 

  22. Collin SM, Martin RM, Metcalfe C et al (2008) Prostate-cancer mortality in the USA and UK in 1975–2004: an ecological study. Lancet Oncol 9:445–452

    Article  PubMed  PubMed Central  Google Scholar 

  23. Etzioni R, Tsodikov A, Mariotto A et al (2008) Quantifying the role of PSA screening in the US prostate cancer mortality decline. Cancer Causes Control 19:175–181

    Article  PubMed  Google Scholar 

  24. Schröder FH, Hugosson J, Roobol MJ et al (2014) Screening and prostate cancer mortality: results of the European Randomised Study of Screening for Prostate Cancer (ERSPC) at 13 years of follow-up. Lancet 384:2027–2035

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgments

We thank the staff of the population-based cancer registries around the world who provided the incidence data used in this paper, and IARC for making the data publically available.

Authors’ contributions

Subas Neupane was involved in data collection/management and data analysis and wrote the manuscript. Freddie Bray was involved in data collection (CI5, GloboCan) and edited the manuscript. Anssi Auvinen was involved in protocol development and data collection and edited the manuscript.

Author information

Authors and Affiliations

  1. School of Health Sciences, University of Tampere, 33014, Tampere, Finland

    Subas Neupane & Anssi Auvinen

  2. Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France

    Freddie Bray

Authors
  1. Subas Neupane
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Freddie Bray
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anssi Auvinen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Anssi Auvinen.

Ethics declarations

Conflict of interest

The authors declare that they have no competing interests.

Ethical standard

The material used is obtained from publicly available databases (IARC and World Bank), and no permissions were required. The data include no person-level information, and therefore, no consent or ethical committee review was required. We have complied with good research practice in the conduct of the study.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Neupane, S., Bray, F. & Auvinen, A. National economic and development indicators and international variation in prostate cancer incidence and mortality: an ecological analysis. World J Urol 35, 851–858 (2017). https://doi.org/10.1007/s00345-016-1953-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00345-016-1953-9

Keywords

Search

Navigation