Prostate
Is prostate cancer usually found late in Korea?
In 27,075 Korean cases, more than half were high-risk at diagnosis. The proportion found early has been falling, not rising.
By Andrew Cho
Reporter
- Published
- Reading time
- 5 minutes
Answer
More often than not, yes: in 27,075 biopsy-confirmed Korean prostate cancer cases from 51 general hospitals, 14,609 — 53.9 percent — were high-risk at diagnosis, against 5.45 percent low-risk, and the share of low-risk disease at diagnosis fell from 11.4 percent in 2010 to 7.6 percent in 2020.
Key takeaways
- In 27,075 biopsy-confirmed Korean prostate cancer cases drawn from 51 general hospitals, 14,609 (53.9 percent) were high-risk at diagnosis, against 1,476 (5.45 percent) low-risk and 1,082 (4.00 percent) potentially low-risk.
- The proportion of low-risk disease at diagnosis fell from 11.4 percent in 2010 to 7.6 percent in 2020.
- High-risk disease accounted for 55.4 percent of cases among rural residents against 47.7 percent among urban residents, which the authors read as a disparity in access to early detection.
- About a quarter of newly diagnosed Korean men — 6,586 of 27,075, or 24.3 percent — were eligible for active surveillance under a deliberately broad definition including favourable intermediate-risk disease.
- That active surveillance eligibility also fell over the decade, from 27.6 percent of diagnoses in 2010 to 22.0 percent in 2020.
- In a separate national cohort of 166,848 Korean men, 26.7 percent had been repeatedly PSA-tested before diagnosis, and those men more often received localised treatment — surgery in 45.6 percent against 33.8 percent.
Countries with long-established PSA testing tend to find prostate cancer early, often too early. Korea's pattern is the opposite, and the trend over the past decade has moved further in that direction rather than back.
What the Korean distribution looks like
A study drawing on 27,075 biopsy-confirmed cases from 51 Korean general hospitals classified each by risk group at the moment of diagnosis.
| Risk group | Cases | Share |
|---|---|---|
| High risk | 14,609 | 53.9% |
| Low risk | 1,476 | 5.45% |
| Potentially low risk | 1,082 | 4.00% |
More than half of Korean men are high-risk when their cancer is found. And the share found at low risk has been shrinking: 11.4 percent of diagnoses in 2010, 7.6 percent in 2020.
Where you live changes the odds
55.4% vs 47.7%
The authors read that gap as a disparity in access to early detection rather than a difference in the disease. It is one of the clearest markers in Korean cancer data that where a man lives affects what stage his cancer is found at.
What it means for treatment choices
Active surveillance — monitoring rather than treating — only applies to cancers found early enough to be safely watched. Using a deliberately broad definition that includes favourable intermediate-risk disease, 6,586 of the 27,075 men, or 24.3 percent, would have been eligible. That share fell too, from 27.6 percent of diagnoses in 2010 to 22.0 percent in 2020.
There is a counterweight worth stating. In a national cohort of 166,848 Korean men, 26.7 percent had been repeatedly PSA-tested before diagnosis, and those men more often received treatment aimed at cure — surgery in 45.6 percent against 33.8 percent of those who had not. Repeated testing is associated with catching disease while it is still localised.
That association is not, by itself, an argument that every Korean man should be PSA-tested. Men who get tested repeatedly differ from men who do not in ways that also predict outcome, and the harms of PSA screening — overdiagnosis and the treatment of cancers that would never have surfaced — are the reason no country recommends it without qualification.
What the Korean figures do establish is that the trade-off here is not the one being debated in countries where over-detection dominates. Korea's problem, at present, runs the other way.
Sources
- 1
Ko YH, Kim SW, Son NH
Incidence of high-risk prostate cancer in Korea: insights from real-world data between 2010 and 2020Journal of Korean Medical Science 2026;41(14):e10
doi:10.3346/jkms.2026.41.e10 · PMID:41978922
https://doi.org/10.3346/jkms.2026.41.e10 - 2
Ko YH, Kim SW, Son NH
Active surveillance could apply to one-quarter of Korean prostate cancer cases: insights from a 27,075-patient cohortProstate International 2026;14(2):127-131
doi:10.1016/j.prnil.2025.12.004 · PMID:42382553
https://doi.org/10.1016/j.prnil.2025.12.004 - 3
Ko YH, Kim SW, Son NH
Impact of repeated prostate-specific antigen testing on management patterns and personal healthcare spending for prostate cancer: a population-based study National Health Insurance data for 166,848 patients in South Korea from 2010 to 2020Investigative and Clinical Urology 2026;67(3):263-272
doi:10.4111/icu.20250537 · PMID:42065662
https://doi.org/10.4111/icu.20250537
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