Regional disparities in prostate cancer mortality in the African Union: A retrospective analysis (1980-2023).

Abstract

5053 Background: Prostate cancer represents a substantial health burden among men in Africa and is an important contributor to cancer-related mortality, with considerable variation observed across African regions. This study uses data from the Global Burden of Disease (GBD) project to evaluate regional variations in prostate cancer age-standardized death rates (ASDR) from 1980 to 2023. Methods: Prostate cancer mortality data were extracted from the GBD 2023 database for the period 1980–2023. Age-standardized death rates (ASDRs) per 100,000 population were obtained for African regions as defined by the GBD classification, including Northern Africa, Central Africa, Eastern Africa, Western Africa, Southern Africa and the African Union aggregate. Temporal patterns from 1980 to 2023 were evaluated using joinpoint regression analysis, and average annual percentage change (AAPC) estimates were calculated to quantify long-term trends. Statistical significance was determined using corresponding p-values (less than 0.05) and 95% confidence intervals. Results: From 1980 to 2023, a gradual rise in the ASDR per 100,000 was observed in the African Union with substantial regional variations. It gradually increased from 8.78 per 100,000 in 1980 to 11.44 per 100,000 in 2023 (AAPC: 0.68; 95% CI: 0.51 to 0.84; p< 0.000001). The highest ASDR were observed in Central Africa. It increased from 13.72 per 100,000 in 1980 to 18.63 per 100,000 in 2023 (AAPC: 0.77; 95% CI: 0.62 to 0.91; p< 0.000001). This was followed by Western Africa increasing from 10.64 per 100,000 in 1980 to 16.06 per 100,000 in 2023 (AAPC: 0.96; 95% CI: 0.82 to 1.09; p< 0.000001). A slight increase was also observed in Southern Africa rising from 10.70 in 1980 to 12.07 (AAPC: 0.26; 95% CI: -0.0045 to 0.543; p< 0.053). Eastern Africa showed a slight increase in ASDR from 8.95 per 100,000 in 1980 to 10.36 per 100,000 in 2023 (AAPC: 0.43; 95% CI: 0.24 to 0.62; p< 0.000009). Northern Africa had consistently the lowest ASDR. It rose from 2.35 per 100,000 in 1980 to 4.32 per 100,000 in 2023 (AAPC: 1.41; 95% CI: 1.27 to 1.56; p< 0.000001). Conclusions: Prostate cancer remains the leading cause of cancer-related death among men in the African Union, particularly in Central Africa. High mortality is driven by limited healthcare access and late-stage diagnosis. Strengthening screening programs and improving specialized care can reduce this rising burden. Trends in age standardized death rate (ASDR) per 100,000 due to prostate cancer in the African Union. Region ASDR 1980 (per 100,000) ASDR 2023 (per 100,000) AAPC (95% CI) African Union 8.79 11.45 0.68* (0.51 - 0.84) Central Africa 13.72 18.63 0.77* (0.62 - 0.92) Eastern Africa 8.95 10.36 0.44* (0.24 - 0.63) Northern Africa 2.35 4.33 1.42* (1.27 - 1.57) Southern Africa 10.70 12.08 0.26* (-0.01 -0.54) Western Africa 10.64 16.06 0.96* (0.82 - 1.10) AAPC = Average Annual Percentage Change; *p< 0.05.