The Association between Spatial-Temporal Distribution of Prostate Cancer and Environmental Factors in Mainland China

Background: In China, the incidence and mortality of prostate cancer are increasing. In this study, we analyzed the spatial -temporal distribution characteristics of prostate cancer incidence and mortality in China and explored the potential associations of socioeconomic, ecological, and meteorologic conditions.Methods: Spatial-temporal scan statistics were used to analyze the spatial-temporal patterns of prostate cancer in China from 2012 to 2016. Spatial regression models and the Geodetector method were used to explore the potential associations of anthropogenic and natural factors with prostate cancer.Results: The incidence and mortality of prostate cancer in China from 2012 to 2016 rapidly increased. The high incidence and mortality clusters were concentrated in the economically developed Yangtze River Delta region along the southeast coast. Among the 14 selected environmental factors, gross domestic product (GDP) per capita, population density, comprehensive index of environmental pollution discharge, accessibility of health care resources, urbani-zation rate, and nitrogen dioxide (NO2) had significant positive correlations with prostate cancer incidence and mortality. GDP per capita, urbanization rate, and population density had high explan-atory power.Conclusions: The high-concentration areas for prostate cancer are located in more economically developed cities. The index of environmental pollution discharge, NO2, and prostate cancer inci-dence and mortality were positively correlated. The government should advocate increasing the use of clean energy while strength-ening the regulation of industrial production to reduce pollutant emissions.Impact: To inform the development of prevention and control strategies for prostate cancer in China.