Are You at Risk of Prostate Cancer?
Prostate cancer is a complex disease, and its development can be influenced by a variety of factors. While the exact cause of prostate cancer is not fully understood, several risk factors have been identified. If you are concerned about your prostate cancer risk, knowing the risk factors of prostate cancer may give you a better awareness about the disease and your chances of getting it.
However, it's important to note that having one or more of these risk factors does not guarantee that a person will develop prostate cancer, and conversely, individuals without any known risk factors can still develop the disease.
Prostate cancer risk factors
Currently, only a few risk factors are considered as established. Different studies exploring these factors have produced generally consistent results.
Age
The risk of developing prostate cancer increases with age. Examination of age-specific incidence patterns indicates that the likelihood of developing prostate cancer is low in men under the age of 40, starts to increase significantly after the age of 55 and reaches its highest point between the ages of 70 and 74, gradually decreasing thereafter. Post-mortem studies validate that prostate cancer grows slowly, with numerous men harboring abnormal but latent tissue growth in their twenties and thirties.
Race/ethnicity
Prostate cancer is more common in African-American men and less common in Asian and Hispanic/Latino men. African Americans face a roughly 60% higher risk of prostate cancer compared to whites. Additionally, African-American men also tend to be diagnosed at a more advanced stage and have a higher mortality rate. The prostate cancer mortality rate for African Americans is approximately twice as high as that of whites. However, the reasons for this are not entirely clear. It is not known if the differences in mortality rates are due to differences in socioeconomic statuses or inherent biological differences that lead to an increased risk, or both.
Family history
Having a close relative (such as a father, brother, or son) who has had prostate cancer increases a man's risk by approximately two to three times. Having a second-degree relative (e.g. grandfather, uncle or nephew) who has/had prostate cancer increases your risk by 1.9 times. The risk is higher if the relative was diagnosed at a younger age.
However, your relatives having it does not necessarily mean that you will eventually develop prostate cancer. In fact, in most prostate cancer cases, there is no family history of prostate cancer.
Prostate cancer risk has also been associated with breast cancer. It was shown in cohort studies that men whose mother has/had breast cancer have a 19-24% higher prostate cancer risk.
Genetics and heredity
Some inherited gene mutations, such as those in the BRCA2 genes, have been associated with an increased risk of prostate cancer. A cohort study showed that the prostate cancer risk is five times higher in men with BRCA2 mutations than the general population. It is still unclear whether BRCA1 genes affect prostate cancer risk.
A meta-analysis and cohort study have also shown that men with Lynch syndrome also have a higher prostate cancer risk of 2.1 to 4.9 times compared to the general population.
Unconfirmed risk factors
There are some risk factors that have been explored but have had inconclusive or mixed results. Some risk factors that are still under investigation are:
Geographic location and migration
Prostate cancer rates vary around the world, with higher incidence rates observed in North America, Northwestern Europe, and Australia. Rates are lower in Asia, Africa, and Central and South America.
One reason for this disparity could be the difference in the prevalence of screening and diagnostic methods. However, other environmental factors relating to a western lifestyle, such as diet, could also affect risk. For example, it was observed in a study that Japanese Americans have an incidence rate 43 times than their counterparts in Asia.
Diet
While not conclusively proven, some studies suggest that a diet high in red meat and high-fat dairy products and low in fruits and vegetables may be associated with an increased risk of prostate cancer.
Learn more: Can Diet Cause Prostate Cancer?
Obesity
Some studies have suggested that obese men may have a higher risk of developing aggressive forms of prostate cancer.
Learn more: Obesity and Prostate Cancer Risk
Inflammation of the prostate
Chronic inflammation of the prostate, known as prostatitis, may be associated with an increased risk of prostate cancer.
Chemical exposures
Some studies have suggested a possible link between certain chemicals and an increased risk of prostate cancer. For example, a meta-analysis of case control studies showed that people highly exposed to pesticides (e.g. in the agricultural industry) are 33% more at risk of developing prostate cancer. Other chemicals such as Agent Orange, a carcinogenic herbicide used during the Vietnam war, have also been studied but results on their influence on prostate cancer have been mixed. However, the US Department of Veteran Affairs recognizes Agent Orange exposure as a risk factor for prostate cancer, and offers compensation for veterans with prostate cancer who were exposed to Agent Orange during service.
Concomitant medical conditions
Some research has explored potential links between certain diseases like diabetes and prostatitis and risk of prostate cancer.
It's important to remember that having one or more of these risk factors does not mean that prostate cancer is inevitable, as many men with several risk factors never develop the disease. Additionally, there are lifestyle modifications and early detection measures, such as regular screenings and check-ups, that can help manage and reduce the risk of prostate cancer. If you have concerns about prostate cancer or any of the risk factors, it's advisable to discuss them with a healthcare professional.