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Incidence and risk factors of LUTS associated with benign prostatic hyperplasia among Chinese men: findings from the CHARLS cohort
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  • Published: 26 February 2026

Incidence and risk factors of LUTS associated with benign prostatic hyperplasia among Chinese men: findings from the CHARLS cohort

  • Chao Lv1,2 na1,
  • Mingyue Zhao3 na1,
  • Qingyang Meng1 na1,
  • Zexuan Lv1,4,
  • Xinze Xia5,
  • Jizhang Xing2,
  • Xiaowei Hao1,
  • Yangyang Wu1,
  • Kaikai Lv1,
  • Qing Yuan1 na1 &
  • …
  • Xu Zhang1 na1 

Scientific Reports , Article number:  (2026) Cite this article

We are providing an unedited version of this manuscript to give early access to its findings. Before final publication, the manuscript will undergo further editing. Please note there may be errors present which affect the content, and all legal disclaimers apply.

Subjects

  • Diseases
  • Medical research
  • Risk factors
  • Urology

Abstract

China’s rapidly aging population is increasing the prevalence and economic burden of lower urinary tract symptoms associated with benign prostatic hyperplasia (LUTS-BPH). However, limited national-scale evidence exists regarding incidence, regional variation, and risk factor patterns among Chinese men. Using data from the China Health and Retirement Longitudinal Study (CHARLS), we followed 6,713 men aged ≥ 45 years who were free of LUTS-BPH at baseline (2011–2012). LUTS-BPH onset was identified through biennial surveys (2013–2018). Age- and region-specific incidence rates were calculated, and multivariable Cox proportional-hazards models were used to identify independent risk factors. During a median follow-up of seven years (38,949 person-years), 1,175 incident LUTS-BPH cases were observed, yielding an overall incidence of 30.2 per 1,000 person-years (95% CI: 28.5–31.9). Incidence increased steadily with age until 75 years and then declined slightly. Predicted cumulative risks among 45-year-old men without LUTS-BPH were 16.7%, 30.6%, and 42.2% over 10, 20, and 30 years, respectively. Significant geographical heterogeneity was observed, with higher rates in Central and southern humid regions. Independent predictors included age, body-mass index, waist circumference, education, perceived health status, smoking, napping time, and residence region.These risk factors varied across different age groups (≤ 60, 60–75, and ≥ 75). LUTS-BPH incidence in Chinese men rises with age and varies substantially by region and lifestyle. Modifiable factors such as central obesity and prolonged napping may guide early risk stratification, though causal relationships require validation in future interventional and mechanistic studies. These findings support targeted, region-specific screening strategies for China’s aging male population.

Data availability

The data can be downloaded from website: https://charls.charlsdata.com/pages/data/111/en.html.

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Acknowledgements

The authors acknowledge Ms. Wen-Jie Liu (Head Nurse, Urology Ward II, First Medical Center, Chinese PLA General Hospital) for her expert coordination in data collection procedures.

Funding

This work was supported by the National Key R&D Program of China (Grant Nos. 2023YFC3605305, 2022YFC3602900 and 2022YFC3602905) and by the Beijing Nova Program (Grant No. 20220484230).

Author information

Author notes

  1. These authors contributed equally to this work: Chao Lv, Mingyue Zhao, Qingyang Meng, Qing Yuan and Xu Zhang.

Authors and Affiliations

  1. Senior Department of Urology, 3rd Medical Centre of PLA General Hospital, Beijing, 100039, China

    Chao Lv, Qingyang Meng, Zexuan Lv, Xiaowei Hao, Yangyang Wu, Kaikai Lv, Qing Yuan & Xu Zhang

  2. Department of Urology, PLA Air Force Medical Center, Beijing, 100142, China

    Chao Lv & Jizhang Xing

  3. Department of Neurosurgery, PLA Air Force Medical Center, Beijing, 100142, China

    Mingyue Zhao

  4. School of Medicine, Nankai University, Tianjin, 300071, China

    Zexuan Lv

  5. The Second Clinical Medical College, Shanxi Medical University, Shanxi, 030001, China

    Xinze Xia

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Contributions

Conceptualization: Xu Zhang, Qing Yuan, and Mingyue Zhao.Study design: Chao Lv, Mingyue Zhao, and Qingyang Meng.Data acquisition: Qingyang Meng, Zexuan Lv, Xinze Xia, Xiaowei Hao, Yangyang Wu, and Kaikai Lv.Data curation and quality control: Jizhang Xing, Qingyang Meng, and Kaikai Lv.Formal analysis: Chao Lv and Qingyang Meng.Methodology and statistical modeling: Chao Lv, Mingyue Zhao, and Qingyang Meng.Visualization and figure preparation: Zexuan Lv, Xinze Xia, and Yangyang Wu.Writing – original draft: Chao Lv and Qingyang Meng.Writing – review & editing: Mingyue Zhao, Qing Yuan, and Xu Zhang.Supervision: Xu Zhang and Qing Yuan.Project administration: Xu Zhang and Qing Yuan.

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Correspondence to Mingyue Zhao, Qing Yuan or Xu Zhang.

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Lv, C., Zhao, M., Meng, Q. et al. Incidence and risk factors of LUTS associated with benign prostatic hyperplasia among Chinese men: findings from the CHARLS cohort. Sci Rep (2026). https://doi.org/10.1038/s41598-026-39227-7

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  • Received: 25 August 2025

  • Accepted: 03 February 2026

  • Published: 26 February 2026

  • DOI: https://doi.org/10.1038/s41598-026-39227-7

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Keywords

  • Lower urinary tract symptoms (LUTS)
  • Benign prostatic hyperplasia (BPH)
  • Incidence
  • Risk factors
  • CHARLS
  • Obesity
  • Geographical variation
  • Aging population
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