Dynamics of the Prostate Cancer Burden in Ukraine Against General European Trends: A Comparative Analysis, 1990–2023

Abstract

Purpose. The study aims to investigate the long-term dynamics and regional disparities of the prostate cancer (PCa) burden across Europe from 1990 to 2023. By comparing Ukraine with other European subregions and representative countries, the research seeks to quantify annual trends in disability-adjusted life years (DALYs), mortality rates, and years lived with disability (YLDs), providing a comprehensive epidemiological outlook. Materials and methods. This study utilized data from the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD 2023). The analysis focused on age-standardized rates (ASR) per 100,000 population to ensure cross-country comparability regardless of demographic differences. The study examined three major European subregions (Eastern, Central, and Western) and 15 selected countries. Key metrics included DALYs, YLDs, and mortality rates. Statistical significance was evaluated using 95% uncertainty intervals (UIs). The Average Annual Percent Change (AAPC) was calculated using an exponential regression model to determine the velocity of epidemiological shifts. Results. The findings reveal a profound divergence in prostate cancer trajectories. Since 1990, Eastern Europe has experienced a dramatic epidemiological shift, with DALY rates surging by 181.27%, contrasted sharply with a modest 10.78% increase in Western Europe. The most significant component of this growth in the East was the YLD index, which skyrocketed by 365.30%, reflecting both improved diagnostic detection and an increasing prevalence of patients living with the disease. In contrast, Western European mortality rates remained relatively stable (+19.63%), suggesting higher therapeutic efficacy. Country-specific analysis identified Moldova and Ukraine as leaders in the annual growth of disease burden, with AAPC values of 3.28% and 2.49%, respectively. Central European countries like Poland (AAPC 2.78%) also showed strong upward trends. Conversely, Northern European countries demonstrated a “maturation” of their epidemiological curves; Sweden (-0.48%) and Denmark (-0.34%) achieved statistically significant annual reductions in their PCa burden. France maintained a stable trend (AAPC -0.15%), indicating a successful plateau in disease impact. Conclusions. The research highlights a critical “East-West” gap in prostate cancer control within the European healthcare landscape. The rapid escalation of DALYs and mortality in Ukraine and Moldova suggests an urgent need for healthcare policy revisions, focusing on earlier stage detection and wider access to innovative hormonal and surgical therapies. The stark contrast between the rising trends in Eastern Europe and the declining burden in Scandinavia underscores the potential of mature screening programs and active surveillance protocols. This study confirms that while PCa remains a significant public health challenge, the experience of Northern Europe serves as a benchmark for achieving sustainable reductions in population-level disease burden. These results provide a vital evidentiary base for national oncology programs in Eastern European countries to mitigate the ongoing epidemiological crisis.