The prevalence of prostate cancer in Pakistan: A systematic review and meta-analysis

BACKGROUND: Prostate cancer is a significant public health issue, ranking as the second most common cancer and the fifth leading cause of cancer-related deaths in men. In Pakistan, the prevalence of prostate cancer varies significantly across published articles. This study aimed to determine the pooled prevalence of prostate cancer and its associated risk factors in Pakistan. METHODS: MEDLINE (via PubMed), Web of Science, Google Scholar, and local databases were searched from inception until March 2023, using key search terms related to the prevalence of prostate cancer. We considered a random-effects meta-analysis to derive the pooled prevalence and relative risks with 95% CIs. Two investigators independently screened articles and performed data extraction and risk of bias analysis. We also conducted meta-regression analysis and stratification to investigate heterogeneity. This study protocol was registered at PROSPERO, number CRD42022376061. RESULTS: Our meta-analysis incorporated 11 articles with a total sample size of 184,384. The overall pooled prevalence of prostate cancer was 5.20% (95% CI: 3.72–6.90%), with substantial heterogeneity among estimates (I(2) = 98.5%). The 95% prediction interval of prostate cancer was ranged from 1.74%–10.35%. Subgroup meta-analysis revealed that the highest pooled prevalence of prostate cancer was in Khyber Pakhtunkhwa (8.29%; 95% CI: 6.13–10.74%, n = 1), followed by Punjab (8.09%; 95% CI:7.36–8.86%, n = 3), while the lowest was found in Sindh (3.30%; 95% CI: 2.37–4.38%, n = 5). From 2000 to 2010 to 2011–2023, the prevalence of prostate cancer increased significantly from 3.88% (95% CI: 2.72–5.23%) to 5.80% (95% CI: 3.76–8.24%). CONCLUSIONS: Our meta-analysis provides essential insights into the prevalence of prostate cancer in Pakistan, highlighting the need for continued research and interventions to address this pressing health issue.