Abstract
BACKGROUND: Prostate cancer is one of the most common cancers among men. As the disease primarily affects older men, it is necessary to evaluate the burden of prostate cancer in older populations. METHODS: We extracted the estimates with uncertainty intervals (UI) for incidence, prevalence, mortality, and disability-adjusted life-years (DALYs) of prostate cancer in older men (aged 70 years and older) from Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021. The burden and temporal trends of prostate cancer in older adults were analyzed at global, regional and country levels in 1990–2021 period. Bayesian age-period-cohort (BAPC) models were utilized to project the global burden of prostate cancer in older adults from 2021 to 2040. RESULTS: In 2021, there were 734,673 (95% UI: 669,126 to 779,148) incident cases, 5,275,652 (95% UI: 4,915,527 to 5,557,959) prevalent cases, 338,640 (95% UI: 298,294 to 362,941) deaths, and 5,097,743 (95% UI: 4,534,592 to 5,489,271) DALYs of prostate cancer in men aged ≥ 70 years worldwide. From 1990 to 2021, the age-standardized incidence and mortality rates declined in high sociodemographic index (SDI) countries while rising in low and low-middle SDI countries. Significant positive correlations were observed between SDI levels and the age-standardized rates for incidence and prevalence. The global burden of prostate cancer in older adults was projected to increase annually over the next 20 years. CONCLUSIONS: Prostate cancer in older adults has become a major public health issue with significant increases in the number of incident cases, prevalent cases, deaths, and DALYs. Targeted prevention and control strategies are urgently needed to address this challenge. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12877-025-06528-x.