How to Deal with the Projected Rise of Prostate Cancer Cases in the Chinese Healthcare System

(UroToday.com) The 2024 Advanced Prostate Cancer Consensus Conference (APCCC) meeting featured a session on global access of advanced prostate cancer in low- and lower-middle income countries, and a presentation by Dr. Dingwei Ye discussing how to deal with the projected rise of prostate cancer cases in the Chinese healthcare system. Prostate cancer incidence is increasing in China, now the 6^th most common male cancer, with 18.61 cases per 100,000 men in 2022:

Moreover, radical prostatectomy volume at Dr. Ye’s institution, Fudan University Shanghai Cancer Center, has dramatically increased over the last decade:

Whether there is a rise or not in prostate cancer cases in China, there is an imbalance in diagnosis, with the majority of cases being diagnosed in urban compared to rural areas:

Dr. Ye also emphasized that prostate cancer ranks 7^th in mortality among male cancers in China, with 5-year survival rates far lower than that of other countries:

Of note, there are epidemiological differences in prostate cancer between China and the United States, with prostate cancer patients in China being diagnosed at a later stage.

Dr. Ye emphasized that one way to deal with the increase in cases in China is the Healthy China Initiative (2019-2030), which was announced by the State Council and is designed to decrease potential life years lost, improve survival outcomes for cancer, and improve early diagnosis rates. Dr. Ye notes that there are policies for cancer screening for breast, upper gastrointestinal, colorectal, liver, and lung cancer, but there is an absence of a screening policy for prostate cancer. As such, local agencies are developing their own screening strategies in the Eastern coastal areas. There is also a push for upgrading medical facilities to improve hospitals and equipment to meet the treatment needs of more patients. Additionally, there is resource integration for medical resources, optimizing medical processes, improving treatment efficiency, and reducing patient economic burden. Currently, there are 314 Da Vinci Surgical Robotic sets in China, with the following distribution in the country, certainly favoring the East:

The current models of the robot include the RONOVO, Jingeng, and Toumai:

An important initiative is acceleration of drug approval. The following examples for enzalutamide and olaparib demonstrate the substantial gap between approvals in the United States and China:

Dr. Ye also notes that China is also working on multidisciplinary collaboration specifically for prostate cancer:

Indeed, in hospital tumor boards started in China in 2005, followed by domestic tumor boards in 2015, and now international tumor boards starting in 2018:

Dr. Ye concluded his presentation by discussing how to deal with the projected rise of prostate cancer cases in the Chinese healthcare system with the following take-home messages:

• The incidence of prostate cancer is rising rapidly in China, with significant imbalances between urban and rural areas, southeastern coastal and central-western regions
• China does not have a national-level PSA screening policy but is exploring screening strategies in economically developed regions
• The Chinese government has made great efforts to enhance public health awareness, accelerate approval of new drugs, introduce new equipment, and support original research
• Chinese experts are actively promoting the multidisciplinary tumor model and internationalization of diagnosis and treatment to improve the prognosis of prostate cancer in China