Temporal trends in prostate cancer incidence, mortality, and survival in the health regions of Sergipe, Brazil, 1996-2022

OBJECTIVE: to examine the temporal trends of these indicators across the state's health regions to provide evidence that supports improvements in public policies and actions aimed at disease control. MATERIAL AND METHODS: Ecological study conducted in Sergipe state, Brazil. We used anonymized data on malignant prostate neoplasms (ICD-10 C61) from the Aracaju Cancer Registry (ACR) for 1996-2017. Mortality data were obtained from the Mortality Information System (SIM) for 1996-2022. Age-specific and age-standardized incidence and mortality rates were calculated. The Mortality-to-Incidence Ratio (MIR) and its complement (1-MIR) were used as indirect indicators of five-year survival. Temporal trends were assessed using Joinpoint regression (version 5.3.0), estimating APC, AAPC and 95 % confidence intervals using Monte Carlo permutation tests. RESULTS: A total of 10,133 prostate cancer cases were recorded from 1996 to 2017. The age-standardized incidence rate increased from 42.4 per 100,000 (1996-2005) to 76.8 per 100,000 (2006-2012), decreasing slightly to 72.3 per 100,000 (2013-2017). The overall annual increase was 6.63 %, with Aracaju showing 6.85 %. Declines occurred only in Nossa Senhora do Socorro from 2007 to 2017 (APC: -1.85; 95 %CI: -3.59; -0.26). Between 1980-2022, age-standardized mortality increased 4.20 % annually (95 %CI: 3.35-4.81), with marked rises in Estância (7.20 %), Propriá (6.02 %), Lagarto (5.53 %), Nossa Senhora da Glória (4.83 %), and Itabaiana (2.89 %). MIR-based survival declined from 76.57 % (1996-1999) to 71.27 % (2015-2017), with increased MIR among adults aged 75 + , decreasing MIR among individuals aged 15-54-especially in the capital-and increases across all age groups in Propriá. CONCLUSION: Prostate cancer in Sergipe demonstrates significant regional and age-related disparities in incidence, mortality, and survival. Rising incidence and mortality, along with adverse MIR trends, underscore the need for targeted health policies to improve early detection, treatment access and long-term outcomes.