The rising worldwide impact of benign prostatic hyperplasia

Abstract

Objectives To describe the trend in the impact of lower urinary tract symptoms attributed to benign prostatic hyperplasia (LUTS/BPH) on a global scale using the Global Burden of Disease (GBD) database. Materials and Methods Using the GBD database, worldwide data aggregated from registries and health systems from 1990 to 2017 were filtered for LUTS/BPH diagnoses. Calculation of years lived with disability (YLD) were compared with other urological diseases. YLD were calculated by a standardized method using assigned disability weights. The GBD‐defined sociodemographic index (SDI) was used to assess impact of LUTS/BPH by global SDI quintile. Results Global Burden of Disease data over the 1990–2017 study period were summarized and global numbers and trends noted with other urological diseases for comparison. A total of 2 427 334 YLD were attributed to BPH in 2017 alone, almost three times more than those attributed to the next highest urological disease, prostate cancer (843 227 YLD). When stratified by SDI quintile, a much lower impact of BPH was found in the bottom three quintiles, despite this subset representing 66.9% of the 2017 world population. Conclusions Lower urinary tract symptoms attributed to benign prostatic hyperplasia exert a rapidly rising human burden far exceeding other urological diseases. As the population ages and men in a lower SDI enjoy increased life expectancy and decreased competing mortalities, a continually accelerating wave of LUTS/BPH can be forecast. These epidemiological trends have serious implications for the future allocation of resources and the global urological workforce.

Global, Regional, and National Incidence and Year Lived with Disability for Benign Prostatic Hyperplasia from 1990 to 2019

“…In 2006, UK spent £44 million on primary care, £69 million on drug treatment, and £101 million for treating BPH associated complications, such as AUR (Devlin et al, 2020). In 2019, an estimate based on a cost and treatment pattern reflective of USA Medicare costs reported that the global medical service costs of BPH reached $73.8 billion annually (Launer et al, 2020). The financial impact of BPH has increased dramatically and will continue to do so.…”

“…Thus, men with asymptomatic BPH may not be diagnosed. Simultaneously, although rare, BPH can cause deaths as a consequence of LUTS induced renal failure and infection (Launer et al, 2020). But the methodology of the GBD study assigned no deaths to the diagnosis of BPH, resulting in the underestimate of the total impact of this disease.…”

“…Although the epidemiological characteristics about BPH have been reported for different regions in previous studies (Arafa et al, 2015;Egan et al, 2015;Lee et al, 2016;Speakman et al, 2015;Zhang et al, 2019), the results varied substantially across studies and cannot be compared directly because of the inconsistences of the diagnostic criteria of BPH, sampling methods and compositions of population studied between literatures. One study reported the burden of BPH at the global level based on the GBD 2017 study (Launer et al, 2020). It only provided limited information about the YLD of BPH without comprehensive regional, national and age-specific data.…”

Epidemiological Trends of Urinary Tract Infections, Urolithiasis and Benign Prostatic Hyperplasia in 204 Countries and Territories From 1990 to 2019

“…On the one hand, the aging population may explain the increased disease burden of BPH (18). On the other hand, uneven allocation of medical resources in underdeveloped areas is still an important challenge, including the underdiagnose, undertreatment, and the disparate ratio of urologists and patients (18,19). In this study, we explored the global burden of these three urologic benign diseases and provided evidence for the targeted formulation of health care policies and the allocation of medical resources in the future.…”

Serenoa repens for the treatment of lower urinary tract symptoms due to benign prostatic enlargement: A systematic review and meta-analysis

“…The burden of disease attributable to LUTS has been increasing in the past years. From 1990 to 2017, the years lived with disability for males of all ages rose from 1.35 million in 1990 to 2.43 million in 2017 [ 3 ]. Diagnosis usually includes patient history, including a formal assessment of symptom severity (using the International Prostate Symptom Score [IPSS] score), physical exam and targeted laboratory testing to assess secondary causes of LUTS [ 4 ].…”