The national and subnational burden of prostate cancer in Italy from 1990 to 2021: results from the Global Burden of Disease Study 2021

BACKGROUND: Prostate cancer (PCa) is the second most prevalent cancer globally and a major cause of disability and mortality. Survival rates heavily depend on the stage at which the disease is diagnosed, with substantial geographical variations in the burden of the disease. METHODS: The Global Burden of Disease (GBD) Study 2021 provides detailed national and subnational estimates for the burden of PCa in Italy. This study reports incident cases and age-standardized incidence rates (ASIR), deaths and age-standardized mortality rates (ASMR), disability-adjusted life years (DALYs) and age-standardized DALYs rates (ASDR), as well as the average annual rate of change (ARC). The PCa-related survival is investigated using the mortality-to-incidence ratio (MIR) for 1990 and 2021. Italian estimates were compared with Global and High-middle Socio-Demographic Index (SDI) countries. RESULTS: GBD 2021 estimated 39,016 new PCa cases, 10,662 deaths, and 173,048 DALYs for Italy in 2021. The average ARC for ASIR was 0.14, while the average ARC for ASMR and ASDR were -0.29 and -0.31, respectively. MIR dropped from 38.0 in 1990 to 23.8 in 2021. At the subnational level, ASIR increased in seven regions, with no regions showing a decrease, while ASMR and ASDR fell significantly in 17 regions. Italy outperformed both global and high-middle SDI countries in reducing PCa mortality and improving survival rates. CONCLUSIONS: PCa remains a critical health issue in Italy. The reduction in ASMR and ASDR indicates progress in early diagnosis and treatment. However, subnational disparities in incidence and mortality highlight the need for targeted healthcare interventions.