Epidemiological trends in prostate cancer across regions of Ukraine, 2018-2023

Abstract

Modern monitoring of the epidemiological situation is essential for timely detection, effective treatment, and rehabilitation of patients, especially in cancer care. Prostate cancer remains a significant concern in Ukraine, not only because of its prevalence but also due to the decline in the male population of reproductive age.

The present study aimed to analyze the dynamics of prostate cancer incidence and mortality, the number of patients registered annually (newly diagnosed and total), the role of preventive examinations, stage distribution, and the accumulation index across different regions of Ukraine during 2018–2023.

Methods. Data were obtained from national statistical collections. Absolute and relative epidemiological indicators of incidence, prevalence, and mortality were analyzed for Ukraine as a whole, for five macro-regions (West, Central, North-East, South-East, South), their constituent oblasts, and Kyiv. Statistical analysis was performed with SPSS and MedStat using chi-square and Fisher’s exact tests; p<0.05 was considered significant.

Results. The highest incidence in 2018–2021 was observed in the South-East, shifting in 2022–2023 to the West and Central regions; the lowest rates were consistently in the South and Kyiv. Since 2022, the share of patients in the West, Central, and North-East has significantly increased (p<0.001). Kyiv reached its highest proportion in 2023 (10.6%, p<0.05). At the oblast level, incidence was highest in Kirovohrad and Kherson (2018–2021), and in Sumy and Cherkasy (2022–2023); consistently lowest in Zakarpattia. Despite temporary declines in 2020 and 2022, the overall number of registered patients rose steadily, with significant differences in 2022–2023 compared to 2018 (p<0.001). The accumulation index increased in all regions since 2020, peaking in 2022, especially in Kharkiv, Kherson, and Zaporizhzhia. Since 2020, the proportion of newly registered cases has declined, with early-stage detection decreasing from 47% (2018) to 35% (2023) and stage IV diagnoses rising from 23% (2019) to 31% (2023). Detection during preventive examinations fell from 21.2% to 8.6% overall, and in Kyiv from 55.2% to 43% (p<0.001). Mortality per 100,000 was highest in the North-East and Kyiv; in 2022, significant decreases were seen in all regions except the West. One-year mortality after diagnosis remained lowest in the South throughout the study period.

Conclusions. Between 2021 and 2023, incidence, new registrations, early-stage detection, and mortality declined, likely reflecting disruptions from COVID-19 and wartime conditions. At the same time, the total number of registered patients and the accumulation index increased, suggesting both rising morbidity and improved survival due to modern onco-urological care. These findings highlight the need for strengthened epidemiological monitoring and administrative measures to support cancer care and rehabilitation in Ukraine.