Understanding Prostate Cancer
Prostate Cancer Risk Factors
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Prostate cancer is the most common non-skin cancer in America, affecting 1 in 6 men. But who is most at risk of getting prostate cancer and why?
There are several major factors that influence risk, and some of them unfortunately cannot be changed.
Age: The older you are, the more likely you are to be diagnosed with prostate cancer. Although only 1 in 10,000 men under age 40 will be diagnosed, the rate shoots up to 1 in 38 for ages 40 to 59, and 1 in 14 for ages 60 to 69.
In fact, more than 65% of all prostate cancers are diagnosed in men over the age of 65. The average age at diagnosis of prostate cancer in the United States is 69 years. After that age, the chance of developing prostate cancer becomes more common than any other cancer in men or women.
Race: African American men are more likely to develop prostate cancer compared with Caucasian men and are nearly 2.5 times as likely to die from the disease. Conversely, Asian men who live in Asia have the lowest risk.
Family history/genetics: A man with a father or brother who developed prostate cancer is twice as likely to develop the disease. This risk is further increased if the cancer was diagnosed in family members at a younger age (less than 55 years of age) or if it affected three or more family members.
Where you live: For men in the U.S., the risk of developing prostate cancer is 17%. For men who live in rural China, it’s 2%. However, when Chinese men move to the western culture, their risk increases substantially.
Men who live in cities north of 40 degrees latitude (north of Philadelphia, PA, Columbus, OH, and Provo, UT, for instance) have the highest risk for dying from prostate cancer of any men in the United States. This effect appears to be mediated by inadequate sunlight during three months of the year, which reduces vitamin D levels.
Risk Factors in Aggressive vs. Slow-Growing Cancers
In the past few years, we’ve learned that prostate cancer really is several diseases with different causes. More aggressive and fatal cancers likely have different underlying causes than slow-growing tumors.
For example, while smoking has not been thought to be a risk factor for low-risk prostate cancer, it may be a risk factor for aggressive prostate cancer. Likewise, lack of vegetables in the diet (especially broccoli-family vegetables) is linked to a higher risk of aggressive prostate cancer, but not to low-risk prostate cancer.
Body mass index, a measure of obesity, is not linked to being diagnosed with prostate cancer overall. In fact, obese men may have a relatively lower PSA levels than non-obese men due to dilution of the PSA in a larger blood volume. However, obese men are more likely to have aggressive disease.
Other risk factors for aggressive prostate cancer include:
- Tall height
- Lack of exercise and a sedentary lifestyle
- High calcium intake
- African-American race
- Family history
- Agent Orange exposure
Research in the past few years has shown that diet modification might decrease the chances of developing prostate cancer, reduce the likelihood of having a prostate cancer recurrence, or help slow the progression of the disease. You can learn more about how dietary and lifestyle changes can affect the risk of prostate cancer development and progression in PCF’s Nutrition, Exercise and Prostate Cancer guide.
Risk and Other Prostate Conditions
The most common misconception is that the presence of non-cancerous conditions of the prostate will increase the risk of prostate cancer.
While these conditions can cause symptoms similar to those of prostate cancer and should be evaluated by a physician, there is no evidence to suggest that having either of the following conditions will increase a man’s risk for developing prostate cancer.
- Benign Prostatic Hyperplasia (BPH) is a non-cancerous enlargement of the prostate. Because the urethra (the tube that carries urine from the bladder out of the body) runs directly through the prostate, enlargement of the prostate in BPH squeezes the urethra, making it difficult and often painful for men to urinate. Learn more about BPH.
- Prostatitis, an infection in the prostate, is the most common cause of urinary tract infections in men. Most treatment strategies are designed to relieve the symptoms of prostatitis, which include fever, chills, burning during urination, or difficulty urinating. There have been links between inflammation of the prostate cancer and prostate cancer in several studies. This may be a result of being screened for cancer just by having prostate related symptoms, and currently this is an area of controversy. Learn more about prostatitis.
More Myths and Non-Risks
Sexual Activity - High levels of sexual activity or frequent ejaculation have been rumored to increase prostate cancer risk. This is untrue. In fact, studies show that men who report more frequent ejaculations may have a lower risk of developing prostate cancer.
Having a vasectomy was originally thought to increase a man’s risk, but this has since been disproven.
Medications - Several recent studies have shown a link between aspirin intake and a reduced risk of prostate cancer by 10-15%. This may result from different screening practices, through a reduction of inflammation, or other unknown factors.
The class of drugs called the statins - known to lower cholesterol - has also recently been linked to a reduced risk of aggressive prostate cancer in some studies.
Alcohol - There is no link between alcohol and prostate cancer risk.
Vitamin E - Recent studies have not shown a benefit to the consumption of vitamin E or selenium (in the formulations studied) in the prevention of prostate cancer.
(Some of the information on this page is adapted from Dr. Patrick Walsh's Guide to Surviving Prostate Cancer.)