Aims: To evaluate current status of prostate cancer incidence and mortality worldwide, and compare the global trends of incidence and mortality in the past two decades and in the most recent period.Methods: Data on the incidence and mortality of prostate cancer for 174 countries in 2020 were obtained from the GLOBOCAN 2020 database, and associations with the human development index (HDI) were evaluated. Data for trend analyses in 89 countries from 2000 to 2019 were retrieved from the Global Burden of Disease 2019 platform. Age standardized incidence rate (ASIR) and mortality rate (ASMR) were calculated by using the Segi's population. The average annual percent changes (AAPC) of ASIRs and ASMRs were evaluated by joinpoint regression analysis.Results: A total of 1 414 259 new cases of prostate cancer and 375 304 related deaths were reported in 2020 globally. HDI was positively correlated with ASIRs (P < 0.001) and negatively correlated with ASMRs (P < 0.001). In the past two decades, ASIRs have been increasing in 65 countries, stable in 15 countries and decreasing in 9 countries, and ASMRs have been increasing in 19 countries, stable in 25 countries and decreasing in 45 countries, respectively. In the most recent period, 44 countries have increasing ASIRs, and 32 countries have decreasing ASMRs, respectively. For instance, in the United States of America, the AAPC of ASIRs significantly decreased by 0.62% and ASMRs significantly decreased by 1.22% from 2000 to 2019, while the AAPC from 2015 to 2019 significantly increased by 0.49% for ASIRs and significantly increased by 0.48% for ASMRs.Conclusion: The magnitude of increasing incidence and decreasing mortality of prostate cancer is attenuated in the recent period. Further study is needed to analyze the absolute effect of risk factors, PSA screening and treatment.

Backgrounds: Cancer is one of the main causes of death worldwide, seriously threatening human health and life expectancy. We aimed to analyze the cancer incidence and mortality rates during 2016 in Zhejiang Province, Southeast China. Methods: Data were collected from 14 population-based cancer registries across Zhejiang Province of China. Cancer incidence and mortality rates stratified by sex and region were analyzed. The crude rate, age-standardized rate, age-specific and region-specific rate, and cumulative rate were calculated. The proportions of 10 common cancers in different groups and the incidence and mortality rates of the top five cancers in different age groups were also calculated. The Chinese national census of 2000 and the world Segi population was used for calculating the age-standardized incidence and mortality rates. Results: The 14 cancer registries covered a population of 14,250,844 individuals, accounting for 29.13% of the population of Zhejiang Province. The total reported cancer cases and deaths were 55,835 and 27,013, respectively. The proportion of morphological verification (MV%) was 78.95% of the population, and percentage of incident cases identified through death certificates only (DCO%) was 1.23% with a mortality-to-incidence ratio (M/I ratio) of 0.48. The crude incidence rate in Zhejiang cancer registration areas was 391.80/10⁵; the age-standardized incidence rate of the Chinese standard population (ASIRC) and the age-standardized incidence rate of the world standard population (ASIRW) were 229.76/10⁵ and 220.96/10⁵, respectively. The incidence rate in men was higher than that in women. The incidence rate increased rapidly after 45 years of age and peaked in individuals aged 80 to 84 years. The top 10 incidence rates of cancers were lung cancer, female breast cancer, thyroid cancer, colorectal cancer, stomach cancer, liver cancer, prostate cancer, cervical cancer, esophageal cancer, and pancreatic cancer (from highest to lowest). The crude mortality rate in Zhejiang cancer registration areas was 189.55/10⁵; the age-standardized mortality rate of the Chinese standard population (ASMRC) and the age-standardized mortality rate of the world standard population (ASMRW) were 94.46/10⁵ and 93.42/10⁵, respectively. The mortality rate in men was higher than that in women, and the male population in rural areas was higher than that in urban areas. The cancer mortality rate increased rapidly after 50 years of age and peaked in individuals aged 85+ years. The top 10 mortality rates of cancers were lung cancer, liver cancer, stomach cancer, colorectal cancer, pancreatic cancer, esophageal cancer, female breast cancer, prostate cancer, lymphoma, and leukemia (from highest to lowest). Conclusions: Lung cancer, female breast cancer, thyroid cancer, colorectal cancer, prostate cancer, liver cancer, and stomach cancer were the most common cancers in Zhejiang Province. Effective prevention and control measures should be established after considering the different characteristics of cancers in urban and rural areas.

As the global population ages, the burden of cancer is increasing. We aimed to assess the impact of population ageing on cancer-related disability-adjusted life years (DALYs). We used the decomposition method to estimate the impact of ageing, population growth, and epidemiological change on cancer-related DALYs from 1990 to 2019, stratified by 204 countries/territories and by their sociodemographic index (SDI). This approach separates the net effect of population ageing from population growth and change in age-specific DALY rates. Cancer-related DALYs among individuals aged ≥65 years increased by 95.14% between 1990 (52.25 million) and 2019 (101.96 million). Population growth was the main contributor to cancer-related DALYs (92.38 million, attributed proportion: 60.91%), followed by population ageing (41.38 million, 27.28%). Cancer-related DALYs attributed to population ageing followed a bell-shaped pattern when stratified by SDI, meaning they peaked in middle-SDI countries. Cancer-related DALYs attributed to ageing increased in 171 and decreased in 33 countries/territories. The top three cancer types with the highest increase in the absolute number of cancer-related DALYs associated with ageing were tracheal, bronchus, and lung (8.72 million); stomach (5.06 million); and colorectal (4.28 million) cancers, while the attributed proportion of DALYs was the highest in prostate (44.75%), pancreatic (40.93%), and non-melanoma skin (38.03%) cancers. Population ageing contributed to global cancer-related DALYs, revealing a bell-shaped pattern when stratified by socioeconomic development, affecting middle-SDI countries the most. To respond to the growing ageing population and reduce cancer-related DALYs, it is necessary to allocate health care resources and prioritize interventions for older adults.

Recent studies suggest a possible link between Helicobacter pylori (H. pylori) infection and risk of colorectal cancer. We examined the association between H. pylori infection, anti-H. pylori treatment, and colorectal cancer and its precursor, adenoma, based on an observational study and a meta-analysis. The observational study part included 3475 participants undergoing colonoscopy and H. pylori testing within the framework of a screening program in Zhejiang Province, China between March 8 and December 29, 2023. Logistic regression models were used to analyze the associations between H. pylori infection and the risk of colorectal cancer and adenoma. Additionally, a meta-analysis was conducted on the associations of H. pylori infection, anti-H. pylori treatment and risk of colorectal cancer and adenoma. Three databases (PubMed, Embase, and Cochrane Library) were searched for relevant studies from inception up to April 9, 2025. Two reviewers independently screened records for eligibility, extracted summary-level data and assessed study quality. Random-effects models were used to calculate the pooled odds ratios (ORs) and 95% confidence intervals (CIs). Study quality was evaluated using the Newcastle–Ottawa Scale for case–control and cohort studies, and adhering to the Agency for Healthcare Research and Quality's recommendations for cross-sectional studies. Heterogeneity was quantified using I² statistics and subgroup analyses were conducted to identify potential sources. We used funnel plots to assess publication bias, and Duval and Tweedie's “trim-and-fill” analysis to correct potential bias. Certainty of evidence was assessed using the Grading of Recommendations, Assessment, Development, and Evaluation system. The protocol for meta-analysis was registered in PROSPERO (CRD42024566640). The observational study found a statistically significant association between H. pylori infection and the odds of colorectal cancer (n = 31, OR = 2.57, 95% CI: 1.26–5.39) and adenoma (n = 1245, OR = 1.37, 95% CI: 1.19–1.59), especially for advanced adenoma (n = 486, OR = 1.94, 95% CI: 1.59–2.38), compared with normal or non-adenomatous lesions (n = 2199). Meta-analysis of this and 54 other studies, with a total of 48,945,236 participants, found that H. pylori infection was positively associated with colorectal cancer (OR = 1.59, 95% CI: 1.39–1.82, I² = 89%) and adenoma (OR = 1.47, 95% CI: 1.36–1.59, I² = 88%), especially with advanced adenoma (OR = 1.77, 95% CI: 1.56–2.00, I² = 65%). The OR of overall colorectal neoplasia (colorectal cancer or adenoma) was 1.49 (95% CI: 1.39–1.60, I² = 91%). Based on meta-analysis of 3 retrospective studies, anti-H. pylori treatment was associated with a reduced overall risk of colorectal neoplasia (OR = 0.44, 95% CI: 0.20–0.97, I² = 93%). H. pylori infection may represent a significant risk factor for the development of colorectal cancer. The effect of anti-H. pylori treatment on colorectal cancer incidence and mortality necessitates further investigation through large-scale, randomized controlled trials with prolonged follow-up durations. This work was supported by 10.13039/501100001809 National Natural Science Foundation of China (No. 82404341, No. 82273704), Noncommunicable Chronic Diseases-National Science and Technology Major Project (No. 2023ZD0501400-2023ZD0501402), Beijing Hospitals Authority’s Ascent Plan (DFL20241102), 10.13039/501100007937 Peking University Medicine Fund for World's Leading Discipline or Discipline Cluster Development (No. BMU2022XKQ004), Science Foundation of Peking University Cancer Hospital (No. BJCH2024BJ02), Healthy Zhejiang One Million People Cohort (K-20230085), 10.13039/501100001659 German Research Foundation (DFG, GE 2042/24-1).

With the increase in the aging population, cancer incidence has markedly increased worldwide. China has a substantial cancer burden, and lung cancer remains the leading cause of cancer-related death, with an estimated 714 699 new deaths in China in 2020.¹ Similar to recommendations released by the US Preventive Services Task Force based on results from the National Lung Screening Trial,^2,3 China, which has one-third of the smoking population in the world,⁴ initiated lung cancer screening programs in 2009 and drafted several versions of guidelines for lung cancer screening using low-dose computed tomography (LDCT).^5-7 In 2021, an advisory group on the formulation of guidelines for lung cancer screening, early diagnosis, and early treatment in China updated the 2018 version⁶ of the guideline by increasing the minimum smoking exposure criterion from 20 to 30 pack-years while maintaining the annual screening frequency, the screening start age of 50 years, and the stop age of 74 years.⁷ The modification of the minimum smoking exposure may substantially increase the detection rate of lung cancer among high-risk individuals who meet the inclusion and exclusion criteria. Because the effectiveness of lung cancer screening for mortality reduction has been confirmed,^2,3 the challenge for lung cancer screening now seems to be the high false-positive rate of LDCT.² Abnormal chest imaging findings may lead to subsequent diagnosis of invasive cancer and related complications according to the current protocols for lung cancer screening in China. The standard procedure in China for participants in whom small pulmonary nodules are detected is performing serial LDCT tests at intervals of 3 to 6 months.^5-7 However, results from the National Lung Screening Trial⁸ demonstrated that 11.7% and 3.5% of the screening findings at baseline and subsequent LDCT tests, respectively, were indeterminate. Meanwhile, the false-positive rates for baseline screening and subsequent tests were 12.8% and 5.3%, respectively.⁸ The prolonged time of uncertainty about the clinical significance of pulmonary nodules, a high use of harmful diagnostic follow-up, the additional frequency of radiation exposure, and increased patient costs and anxiety may contribute to uncertainty about the cost-effectiveness of lung cancer screening.^9,10 Thus, there is a need to improve the accuracy of lung cancer screening to avoid unnecessary LDCT, diagnostic tests, and extra radiation exposure and to decrease overall morbidity.