Rising prostate cancer incidence in Sub-Saharan Africa: A trend analysis of data from the african cancer registry network

Background: Prostate cancer is the leading cancer in men in sub- Saharan Africa (SSA) regarding incidence and mortality. Published data from a few registries in SSA suggest that the rates are still rising, but there is little comprehensive information on the time trends of prostate cancer incidence. Methods: We analyzed registry data on 13,170 incident prostate cancer cases in men aged 40 years or above, from 12 populationbased cancer registries in 11 SSA countries, with at least a 10-year time span of comparable data. Results: We observed an increase in cumulative risks (CR) and age-standardized incidence rates (ASR) over time in all registries (statistically significant in all but one). The highest values ofCRwere found in Seychelles and Harare (Zimbabwe). The highest annual increase in the ASRs was seen in Seychelles and Eastern Cape (South Africa), whereas the lowest was seen in Mauritius. We mainly found a steady increase in incidence with age and during successive periods. Conclusions: This analysis reveals that prostate cancer incidence rates are rising in many populations in SSA-often very rapidly- which is in contrast to recent observations worldwide. We acknowledge that the reasons are multifactorial and largely remain unclear, but believe that they are primarily associated with improvements in health care systems, for example, a broader use of prostate-specific antigen testing. Impact: This study is the first to compare population-level data on time trends of prostate cancer incidence between multiple countries of SSA, presenting the different rates of increase in 11 of them.