Prostate Cancer Research, 2000-16, its Citation Impact and its Influence on Clinical Practice Guidelines

We evaluated prostate cancer research outputs from leading countries to see if they reflected the countries’ research expenditure and disease burden and determined their impact. Were the countries making the largest contribution to the evidence base of clinical practice guidelines (CPGs) for prostate cancer also those whose papers received the most citations on papers? We selected papers in the Web of Science (WoS) from 2000-16 with a complex search filter and analysed their characteristics and citations. We compared countries’ outputs with their overall research expenditure and their burden of disease from prostate cancer. We collected 71 clinical practice guidelines (CPGs) from 28 countries and downloaded their references. Although world output increased from 1696 to 4329 papers over the study period, prostate cancer research represented only 3.6% of all cancer research in 2016. Europe’s relative output was less than half its relative cancer burden and that of Africa only one sixth, but Asia, whose men are less likely to suffer from the disease, published a proportionate amount. The USA still has the largest output (31% of the total, down from 53% in 2000) but China’s output has risen very rapidly and is now second. The US and Netherlands papers were the most cited in the WoS and those from Belgium, the Netherlands and Sweden were the most cited on the CPGs. These CPG references involved research on the main treatments but relatively few on genetics. Some countries’ CPG references were rather old. Prostate cancer research is relatively neglected in Europe and particularly in Africa, but receives more attention in North America, the only continent where its disease burden relative to all cancer has actually declined. The best-performing countries in terms of their influence on CPGs differed from those with the best citation records on the WoS.