Prostate Cancer Risk a Blend of Factors

December 11, 2019
Frieda Wiley, PharmD

Frieda Wiley, PharmD, BCGP, is a writer and pharmacist.

Prostate cancer is the second most common cancer in men after skin cancer. Approximately  175,000 men living the United States were diagnosed with prostate cancer, and the condition claimed more than 30,000 lives in 2019, according to the American Cancer Society.

Slightly more than 10% of men will receive a diagnosis of prostate cancer and certain factors increase a man’s risk for developing the disease. Men who are of African American or Caribbean descent are more likely to develop prostate cancer and they are often younger when diagnosed.

Age is also a factor. In fact, nearly 60% of men diagnosed with prostate cancer are 65 years of age or older, with 66 being the average age at diagnosis. The condition is much less common in men less than 40 years of age. A man’s risk of developing prostate cancer soars after age 50. Asian American and Hispanic men do not get prostate cancer as often as non-Hispanic white men, but why this is the case remains unclear.

Geography also appears to contribute to a man’s risk of developing prostate cancer, as the condition is more common in men who live in northwestern Europe, Australia, North America, and the West Indies. The condition is less common in Africa, Asia, South America, and Central America. Although researchers have yet to figure out the reason for the geographical differences, some attribute these differences to the fact that some developed countries conduct more comprehensive prostate cancer screenings. However, lifestyle habits that are preserved among racial or cultural groups-regardless of the country in which they reside-are also thought to contribute to these geographical differences. For example, Asian men living the United States are less likely to develop prostate cancer than their white male counterparts; however, they are more likely to develop prostate cancer than men living in Asia who share similar ethnic backgrounds.

Genetics can contribute to prostate cancer risk; however, they appear to do so to a lesser extent than some other cancers. Inherited mutations in the BRCA1 and BRCA2 genes famously associated with increasing the risk of breast and ovarian cancer women are also associated with an increased risk of prostate cancer in men. Mutations in the BRCA2 gene, in particular, are linked to increased prostate cancer in men. Additional mutations can also increase the risk for prostate cancer. A genetic disorder known as hereditary non-polyposis colorectal cancer (HNPCC), or Lynch syndrome also increases a man’s chances of developing prostate cancer in addition to the cancers. The condition is caused by inheriting a faulty DNA mismatch repair gene such as MSH2, MSH6, MLH1, and PM52. Mutations in DNA repair genes such as CHEK2, ATM, PALB2, and RDA51D also increase a man’s risk for developing prostate cancer.

Lastly, lifestyle habits appear to influence a man’s likelihood for developing prostate cancer, although the degree to which they play a role is not fully clear. Diets containing high-fat foods, dairy products, and red meat while low in fruits and vegetables appear to slightly increase the risk of prostate cancer. However, obesity studies have produced conflicting results regarding the role of obesity in developing the disease. Some data show obese men are less likely to develop low-grade prostate cancer, but those who get prostate cancer are more likely to have a more aggressive form of the disease. Obese men stand a greater chance for developing advanced prostate cancer and cancer-related mortality, but some studies suggest the contrary.

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