What increases your risk of prostate cancer?

Prostate cancer is the second most common cancer in men. According to the American Cancer Society, 1 in 8 men will be diagnosed with prostate cancer during their lifetime — and 1 in 41 will die from the disease.

While lifestyle choices, such as diet and exercise, show a small link to reducing the likelihood of prostate cancer developing, the majority of risk factors cannot be changed.

“The truth is that all men are at risk for prostate cancer,” says Dr. David Hatcher, a board-certified urologist affiliated with Sharp Memorial Hospital. “However, most cases are diagnosed when the disease is contained within the prostate. With appropriate management, the chances for survival are high.”

The most common risks for prostate cancer

Age
According to Dr. Hatcher, prostate cancer is rarer in men younger than 40 and increases continuously with age. About 6 in 10 cases of prostate cancer are found in men older than 65.

“For this reason, clinical guidelines don’t recommend routine screening in younger men as well as older men with other competing diseases and shorter life expectancies,” says Dr. Hatcher.

Race and ethnicity
Race and ethnicity are significant risk factors for prostate cancer. In particular, Black men have the highest incidence and mortality rates for prostate cancer — more than twice as high as those for white men. Black men also tend to develop prostate cancer at a younger age.

“While the exact reasons for these disparities are not fully understood, research suggests that genetic and biological factors may play a role,” says Dr. Hatcher.

For example, some studies have found that certain gene variants are more common in Black men with prostate cancer. Black men also tend to have higher levels of certain hormones that can stimulate prostate cancer growth.

In addition, social and environmental factors, such as access to health care and exposure to certain toxins, may also contribute to racial disparities in prostate cancer outcomes.

Geography
Prostate cancer is most common in North America, northwestern Europe, Australia and on Caribbean islands. It is less common in Asia, Africa, Central America and South America.

While the reasons are unclear, the more intensive screening for prostate cancer in some developed countries is thought to account for part of this difference. Other factors, such as lifestyle differences and predispositions, are also likely important.

Family history
“If you have a father or brother with prostate cancer, your risk more than doubles of developing the disease, and the risk increases with the number of affected close relatives,” says Dr. Hatcher. “This means if prostate cancer is prevalent in your family, especially a relative diagnosed young, it is important to be proactive in getting screened.”

Included in family history are inherited gene mutations that have been shown to increase the risk. “While only accounting for a small percentage of overall cases, the inherited mutation of the BRCA1 or BRCA2 genes or lynch syndrome have been linked to increased prostate cancer risk in men,” says Dr. Hatcher.

Screening
There is no guaranteed way to prevent prostate cancer. However, being aware of these risk factors and practicing lifestyle choices that include a healthy diet and exercise can play a role in slowing the development of the disease.

“If you are a man over 50 at average risk or have a family history of prostate cancer, it's important to talk to your doctor about screening and other measures to help protect your health,” says Dr. Hatcher.

Once all factors are considered by your health care provider, men who want to be screened may get the prostate-specific antigen (PSA) blood test. This small test will share PSA levels that indicate your risk for prostate cancer.

If levels are high, further testing will be recommended. Because prostate cancer often grows slowly, it allows for men to consider options for both testing and if diagnosed, treatment.

“With early detection and treatment, many cases of prostate cancer can be successfully managed, allowing men to enjoy a long and healthy life,” says Dr. Hatcher.

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