Prostate Cancer in Asia: Epidemiology, Association with Human Development Index and Projections to 2040

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Purpose: This study aimed to characterize the incidence and mortality of contemporary prostate cancer (PCa) across Asian countries, assess their association with the level of national development, and estimate the future regional burden of PCa by 2040. Results: In 2020, Asia accounted for 371,225 of 1,414,259 global incident PCa cases (26.2%) and 120,593 of 375,304 deaths (32.1%). Incidence and death counts were concentrated in China, Japan, and India across 47 Asian countries. The Human Development Index (HDI) showed a positive correlation with the age-standardized incidence rate (ASIR) (r = 0.59, p = 0.000025) and with key components, including life expectancy (r = 0.59), mean years of schooling (r = 0.54), and income per capita (r = 0.46). The age-standardized mortality rate (ASMR) correlated more modestly with HDI (r = 0.30, p = 0.049979) and showed mixed associations with its components. Several countries reported mortality counts that exceeded incident counts, indicating substantial limitations in cancer registration and vital statistics. Under demographic-change assumptions (baseline rates held constant), Asia is projected to contribute the largest absolute global increases by 2040: +349,434 incident cases and +135,911 deaths versus 2020. Ten countries are expected to account for most of the regional rise. Conclusions: Asia already contributes more than one-quarter of global PCa cases and one-third of deaths, and is on track for the largest absolute increase in PCa burden by 2040. Clinically, these trends imply a rapid rise in the demand for urologic, radiation, and medical oncology services, particularly in countries projected to shoulder the greatest increases. The strong HDI-ASIR gradient is biologically plausible, reflecting longer life expectancy, westernization of diet and lifestyle, and wider use of prostate-specific antigen testing in more developed settings, while the weaker HDI-ASMR association suggests that early detection and effective treatment are not yet consistently translating into survival gains. From a public health perspective, the findings support tailored regional strategies: scaling risk-adapted early detection and survivorship programs in higher-HDI systems and prioritizing diagnostic capacity, multimodal treatment access, financial protection, and registry strengthening in lower- and middle-HDI countries. Focusing investments on countries expected to experience the largest absolute increases offers a direct route to limiting mortality growth by 2040.

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