Early-onset cancers, often referred to cancers that occur in those who are less than 50 years old, are indicated to be more prevalent over past decades. Significantly, early-onset prostate cancer could cause more burden for individuals. Firstly, the impact on reproductive ability after surgical procedures is more significant for young people. Secondly, prostate cancer have a high recurrence rate which means that young patients will spend a longer time facing the risks of recurrence. Hence, we aimed to demonstrate the incidence, burden, prediction, and risk factors of early-onset prostate cancers to cast light on early-onset prostate tumor prevention and management.

The Global Burden of Diseases Study 2021 was utilized for this research. Age-standardized incidence rate and the Bayesian age-period-cohort were applied to predict the incidence rate in the future. Estimated annual percentage change of the rates was utilized to evaluate the epidemic trends of early-onset prostate cancer.

The number of incident cases was 6,568 (95% UI, 5,771-7,053) for early-onset prostate cancer (EOPCa) in 1990 and was 17,865 (95% UI, 15,617-19,483) in 2021. ASIRs for EOPCa increased from 1990 to 2021 (from 0.29 [95% UI, 0.29-0.30] to 0.43 [95% UI, 0.42-0.43]). EOPCa was estimated to be associated with 2,861 (95% UI, 2,263-3,242) death cases in 2021 with EAPC of -0.66 (95% CI, -0.78 to -0.54).

We found that (1) globally, the incidence of early-onset prostate cancer rates increased, with early-onset prostate cancer projected to continue rising; (2) the spectrum of early-onset prostate cancer varies across different SDI levels, regions and countries, while early-onset prostate cancer had the highest burden among the three cancer types in most regions; (3) tobacco smoking was a significant risk factor for early-onset prostate cancer and has shown a continued upward trend between 1990 and 2021.