Prostate Cancer Risk Factors

A risk factor is something that increases a person?s chances of getting cancer. Risk factors do not necessarily cause cancer. Rather, they indicate a person?s chances for getting a particular disease.

Uncontrollable Risk Factors

Uncontrollable risk factors are risk factors that cannot be changed, such as gender, age, race and genetics.

Age

One risk factor for prostate cancer is age. Simply growing older increases a man?s risk for getting prostate cancer. More than 75 percent of prostate cancer cases are diagnosed in men ages 65 or older; just 7 percent of cases occur in men younger than age 60. The average age at diagnosis is 72.

Genetic Risk Factors

Gender
The prostate gland is found only in men. Therefore, only men get prostate cancer.

Family History
Family history also may play a role. For instance, risk increases for men whose father or brothers have prostate cancer. The risk is more than 10 times higher for a man who has three relatives with the disease. Risk may also be increased to some extent for men whose female relatives have a high incidence of breast cancer.

Race
Prostate cancer is about twice as common among African-American men as it is among white American men. It is also most common in North America and northwestern Europe. It is less common in Asia, Africa, Central America and South America.
 

Controllable Risk Factors

Controllable risk factors are those that can be changed.

Surgery

Researchers also are looking at the role of vasectomy in prostate cancer. Vasectomy is a surgical procedure that prevents men from fathering children. Some studies have suggested that vasectomies increase the risk of prostate cancer, although most other studies have failed to find such a link.

Diet

Researchers are investigating whether diet is linked to prostate cancer. Men with a diet high in animal fat and low in fruits and vegetables are at an increased risk for prostate cancer. For example, in countries such as China and Japan, where low-fat diets are the norm, few men are diagnosed with prostate cancer. However, the incidence of prostate cancer is considerably higher among men who move from these countries to the United States, and the higher incidence persists in their sons? generation, perhaps due to the change in diet.

Lifestyle

Since prostate cancer is less common in populations with low-fat, high-fiber diets, scientists are also looking into the possibility of using diet to prevent prostate cancer from developing. There is still no evidence to show that switching to a healthy diet after years of eating high-fat foods will make a difference, but small studies are testing the effects of a low-fat, high-soy diet among men who have an increased risk of prostate cancer and men who have already been treated for prostate cancer. One study found less prostate cancer among men who eat lots of tomato-based foods, especially tomato sauce cooked with a little olive oil. Tomatoes, grapefruit, and watermelon are rich in a substance called lycopenes and may help lower prostate cancer risk.

Medication (Prevention Trial)

Researchers are investigating the possibility that drugs might keep latent prostate cancers from developing into active cancers. In the NCI?s Prostate Cancer Prevention Trial (PCPT), 18,000 healthy men ages 55 or older are taking either finasteride (currently used to shrink the prostate in BPH) or a placebo every day for 7 to 10 years. Smaller trials are testing a variety of other medications or chemicals for their ability to prevent prostate cancer.

Screening

The theoretical advantage of finding cancers early, before they cause symptoms, is that early cancers are less likely to have spread and may be easier to treat. Like other advanced cancers, advanced-stage prostate cancer can be a terrible disease.

But the disadvantage of screening is that it often leads to unnecessary additional diagnostic procedures.

Two basic questions still have no definitive answers: How frequently do the screening procedures such as Prostate-Specific Antigen (PSA) and Digital Rectal Exam (DRE) identify cancer? How frequently will finding prostate cancer produce a net benefit?

Studies designed to answer these questions are under way, but results will not be available for years. Earlier studies have a variety of shortcomings, and none have proven that screening for prostate cancer decreases the risk of dying from the disease.

Lacking clear-cut answers, different organizations propose different guidelines. For example:

• Since 1992, the American Urological Association has recommended both DRE and PSA for screening men over age 50 without symptoms, and for men over age 40 who have a family history of prostate cancer or who are African-American.
   
• The American Cancer Society (ACS) recommends that both the PSA blood test and DRE should be offered annually to men ages 50 or older with at least a 10-year life expectancy. ACS adds that all men who are offered the option of screening should be given complete information on the benefits and risks of the procedures. African-American men or men with a strong family history of prostate cancer may be offered screening earlier, at age 45, for example. A strong family history means that prostate cancer has been detected in two or more first-degree relatives such as father or brother.
   
• The United States Preventive Services Task Force its Canadian counterpart, and the American College of Physicians take a different position from that of the American Urological Association and the American Cancer Society: They do not recommend the use of the PSA test for routine screening.

As you can see, opinions vary widely. Few doctors would recommend screening to a man older than age 80 or to a man in poor health. But for most men there is no "right" answer. It is important for you to make your own decision, taking into consideration the advice of your doctor and the best, most up-to-date information you can gather.

Do you want to be screened for prostate cancer?

In coming to your decision, it?s important to consider how you would respond to a diagnosis of cancer. Prostate cancer is usually a slow-growing type of disease, but there are some fast-growing prostate cancers as well. Doctors can't always be sure what type of prostate cancer growth is present in your particular case. If you find out that you have prostate cancer, would you be able and willing to undergo surgery or radiotherapy, which carry the risk of incontinence and sexual impotence?

If you answer "yes," screening is an option. If "no," screening for prostate cancer may not be for you.

American cancer society prostate cancer screening guidelines all men over the age of 50 should talk to their doctors about having the PSA blood test and a digital rectal exam. Men in high-risk groups (African Americans, men with close family members who have had prostate cancer) should talk to their doctors about starting screenings at a younger age.