Incidence & Mortality

Prostate cancer is the second most frequently diagnosed cancer in males worldwide, accounting for 14% of the total new cancer cases in 2008.  About 9% (82 691) were diagnosed within the East Asia (8.2/100 000). Japan accounts for 47%, followed by China (41%) and Korean (8%). Incidence rates (IRs) varied by almost 10-fold across this region, ranging from estimates of 2.56/100 000 in rural China up to 31.2/100 000 in Japan. Except for rural China, Prostate cancer incidence increased steadily over the last decade in other East Asia area. The changing trend was most significant in Korea, with an annual percentage change of 12.8. Prostate cancer was ranked as the fifth most common cancer and also the most common genitourinary cancer in developed areas such as Korea, Japan, Taiwan region and Shanghai.

In 2008, 10% (26 751) of patients who died of Prostate cancer were located in East Asia (2.5/100 000). China accounts for 53%, followed by Japan (37%) and Korea (5%). There was less variation in the age-standardized mortality rate (MR) for Prostate cancer, with the highest in Taiwan region and 4 times greater than in rural China ([Figure 4]). Prostate cancer was ranked as the seventh most common cause of cancer-related deaths in a developed area as Korea, Japan, and Taiwan region. For the trend of mortality, we found most of the area shares a similar plateau pattern. Specifically, a significant decrease in mortality was observed in Japan.

Risk Factors

Diet plays a major role in Prostate cancer carcinogenesis and biology. In Western countries, diet tends to be high in animal products and fine processed, while in Eastern countries, the diet is relatively lower in calories and is more likely to contain greater amounts of certain essential nutrients. Many epidemiological studies showed that increased fat and meat intake is associated with Prostate cancer risk, most studies (including one study from China, of which the odds ratio was 3.3 found positive associations (odds ratio [OR] >1.3) between total fat intake and the risk of Prostate cancer while slightly fewer failed to find this relation. The data on meat and Prostate cancer are more consistent than those on fat, 16 of the 22 studies reviewed showed a risk ratio of 1.3 or more, of which included one study from Japan (OR = 2).

Tea, a traditional drink in East Asia, is found to have a protective effect for Prostate cancer. Zheng et al. indicated that green tea may have a protective effect on prostate through a meta-analysis, the summary odd ratio of Prostate cancer indicated a borderline significant association in Asian populations for highest green tea consumption versus non/lowest (OR = 0.62). The protective capacity of green tea is also confirmed by Japanese studies, the multivariate relative risk was 0.52 for men drinking five or more cups/day compared with <1 cup per day. Soybean, as another traditional food in East Asia, also has anti Prostate cancer effect. A meta-analysis including eight epidemiological studies showed that soybean intake can reduce the prevalence of Prostate cancer for more than 30%. It is said that soybeans are a rich source of isoflavones, a main type of plant estrogens, which have been suggested to modulate endogenous hormone homeostasis or hormone metabolism.

Physical activity has shown to be linked to a significantly decreased risk of breast and colorectal cancer in numerous studies, in Prostate cancer the evidence was weaker but still probable in a Poland study. A study from Malaysia indicated that the past history of not engaging in any physical activities at the age of 45-54 years old increased risk of Prostate cancer by approximately three folds (adjusted OR 2.9 [95% confidence interval = 0.8-10.8]) (P < 0.05). However, a study for Asian-Americans didn’t support the linkage. Limitations of these results exists that the methods are various in the assessment of physical activity, including its frequency, duration and intensity.

The change of diet and lifestyle inevitably resulted in obesity. The increased prevalence of obesity was evidenced in East Asia. Using WHO criteria, the percentage of overweight men in Japan, Korea, and China are 30.1%, 34.3%, and 25.5% in 2008. Furthermore, raised cholesterol was found in 57%, 42.2%, and 31.8%, respectively. The rising trend of metabolism disorders may be responsible for increasing trend of Prostate cancer in East Asia.

Treatment

Treatment for prostate cancer include active surveillance, radiation therapy, brachytherapy, radical prostatectomy, androgen deprivation therapy, and chemotherapy.

At International Cancer Specialists (ICS), we relentlessly strive to provide our patients compassionate and competent care. Led by qualified and experienced oncology clinicians and healthcare managers, as well as a multidisciplinary team of medical specialist partners (all of whom are UK or/and US Board-Certified), ICS stands ready to deliver cutting-edge patient-centered care in a welcoming environment.

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References:

Zhu, Y., Wang, H., Qu, Y., & Ye, D. (2015). Prostate cancer in east asia: Evolving trend over the last decade. Asian Journal of Andrology, 17(1), 48-57. doi:http://dx.doi.org/10.4103/1008-682X.132780

Akaza, H., Onozawa, M., & Hinotsu, S. (2017). Prostate cancer trends in asia. World Journal of Urology, 35(6), 859-865. doi:http://dx.doi.org/10.1007/s00345-016-1939-7