Prostate cancer is a common malignancy originating in the prostate gland, a small, walnut-shaped organ below the bladder in men. While its exact causes are not fully understood, several factors increase a man’s risk. Understanding these influences helps assess personal risk and guide screening strategies.
Age as a Factor
Age is the most significant non-modifiable risk factor for prostate cancer. The likelihood of developing the disease sharply increases after age 50. Approximately 60% of all prostate cancer cases are diagnosed in men over 65, with the average age at diagnosis being 66. By age 80, the chance of developing prostate cancer is nearly 60%. This indicates a cumulative risk over time.
Genetic Predisposition and Family History
A family history of prostate cancer significantly increases a man’s risk. Having a father, brother, or son diagnosed with prostate cancer more than doubles an individual’s risk. The risk becomes even higher if multiple close relatives are affected, particularly if diagnosed at a younger age.
Inherited gene mutations account for an estimated 10% of cases. For example, mutations in the BRCA1 and BRCA2 genes increase prostate cancer risk, with BRCA2 mutations being more strongly linked to aggressive prostate cancer. Lynch syndrome can also predispose men to aggressive prostate cancer.
Racial and Ethnic Disparities
Race and ethnicity significantly influence prostate cancer risk and outcomes. African American men have the highest incidence globally and a mortality rate more than twofold higher than White men. Between 2012 and 2018 in the United States, the age-adjusted incidence rate for Black men was 171.6 per 100,000, compared to 97.7 per 100,000 for non-Hispanic White men.
This disparity is particularly pronounced in younger Black men. Conversely, Asian American and Hispanic/Latino men generally have lower risks. Contributing factors include genetic differences, socioeconomic factors, and varying access to healthcare.
Lifestyle and Environmental Influences
Dietary habits are thought to influence prostate cancer risk, though research in this area is ongoing. A high intake of red and processed meats, especially when cooked at high temperatures, may be associated with an increased risk of prostate cancer. This link might be due to heterocyclic amines (HCAs), carcinogens formed during high-temperature cooking. Consuming large amounts of high-fat dairy products, including whole milk, may also slightly increase the risk of prostate cancer, particularly aggressive or metastatic forms.
Conversely, diets rich in fruits, vegetables, legumes, fish, and whole grains, which are high in fiber, vitamins, and phytochemicals, are associated with a reduced risk of prostate cancer and overall mortality. For instance, men who consumed at least 28 servings of vegetables per week showed a reduced risk compared to those who ate fewer than 14 servings.
Obesity is another lifestyle factor linked to an increased risk of aggressive prostate cancer. Studies suggest that while obesity may not increase the overall risk of prostate cancer diagnosis, it is associated with a higher likelihood of developing advanced or aggressive forms of the disease. Overweight or obese men face a greater risk of prostate cancer being diagnosed at a later stage or being more likely to recur after treatment. This connection may involve altered hormone levels, growth factors, or chronic inflammation.
The potential links between smoking, inflammation, and exposure to certain chemicals are also areas of ongoing research. Some studies indicate that while smoking may not directly increase the risk of developing prostate cancer, it can worsen the outlook for those diagnosed, potentially leading to more aggressive disease or increased mortality. Exposure to chemicals such as Agent Orange, a herbicide used during the Vietnam War, has been associated with an increased risk of prostate cancer among exposed veterans, who often present with more aggressive forms of the disease. Although the exact molecular mechanisms are not fully understood, these environmental factors suggest that lifestyle choices and specific exposures can play a role in prostate cancer risk.