Prostate Cancer Risk Factors
The only well-established risk factors for prostate cancer are age, race/ethnicity, and family history of the disease. In the United States, history of screening has become a risk factor for diagnosis.
Age
Prostate cancer is primarily a disease of older men. Over the last 30 years, there has been a trend toward a larger number of younger men being diagnosed. Prior to the PSA screening era, the median age at diagnosis was 70 years. The median age at diagnosis over the past decade was 67 years. The incidence rate in 2005 relative to 1986 was 0.56 in men aged 80 years and older, 1.09 in men aged 7079 years, 1.91 in men aged 6069 years, 3.64 in men aged 5059 years, and 7.23 in men younger than age 50 years .
In 2005, less then 10% of men diagnosed in the United States were less than 55 years old. Approximately one-third were aged 5564 years, another third were aged 6574, and nearly one-fourth of all men diagnosed were aged 75 years or older.
The age distribution of men diagnosed during the period 20032008 is shown in Table 2. Age-specific incidence and mortality rates for black and white Americans are shown in Figure 2. Risk of diagnosis goes down dramatically after age 80, but risk of prostate cancer death increases throughout adult life.
Age-specific incidence and mortality rates for black and white American men as measured in the National Cancer Institute Surveillance Epidemiology and End Results program for diagnosis or death between 2003 and 2007.
Screening
Data Sources And Methods
The sources and methods used in compiling the estimates in GLOBOCAN 2018 are described in detail elsewhere and also are available online at the Global Cancer Observatory . The Global Cancer Observatory website includes facilities for the tabulation and graphical visualization of the GLOBOCAN database for 185 countries and 36 cancers by age and sex.
The profile of cancer, globally and by world region, is built up in GLOBOCAN using the best available sources of cancer incidence and mortality data within a given country therefore, validity of the national estimates depends on the degree of representativeness and the quality of source information. The methods used to compile the 2018 estimates are largely based on those developed previously, with an emphasis on the use of short-term predictions and modeling of incidence-to-mortality ratios, where applicable. The list of cancer sites, however, has been extended to 36 cancer types in GLOBOCAN 2018, with one of the major additions being estimates of the incidence of, and mortality from, nonmelanoma skin cancer . Together with all cancers combined, cancer-specific estimates are provided for 185 countries or territories worldwide by sex and for 18 age groups .
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Prostate Cancer Incidence By Uk Country
Prostate cancer is the most common cancer in males in the UK, accounting for 27% of all new cancer cases in males .In females and males combined, prostate cancer is the 2nd most common cancer in the UK, accounting for 14% of all new cancer cases .
Prostate cancer incidence rates rate ) for males are significantly higher than the UK average in England and Wales and significantly lower than the UK average in Scotland and Northern Ireland.
For prostate cancer, there are few established risk factors therefore differences between countries largely reflect differences in diagnosis and data recording.
Prostate Cancer , Average Number of New Cases Per Year, Crude and European Age-Standardised Incidence Rates per 100,000 Population, UK, 2016-2018
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About The Canadian Cancer Statistics 2017
Canadian Cancer Statistics is an annual series that began in 1987. This edition was developed by cancer surveillance experts on the Canadian Cancer Statistics Advisory Committee, who were brought together by the Canadian Cancer Society, the Public Health Agency of Canada and Statistics Canada. The publication is designed to help health professionals, policy-makers and researchers make decisions and identify priority areas.
Prostate cancer is the most common noncutaneous cancer in males in the United States. It is estimated that about 60-70% of older men on autopsy have some degree of prostate cancer, compared with 15-20% of men diagnosed with prostate cancer during their lifetime and with the 3% lifetime risk of death from prostate cancer. An estimated one in six white men and one in five African-American men will be diagnosed with prostate cancer in their lifetime, with the likelihood increasing with age. Prostate cancer is rarely diagnosed in men younger than 40 years, and it is uncommon in men younger than 50 years.
Obesity Insulin And Physical Activity
Obesity is linked to advanced and aggressive prostate cancer , and high body mass index is associated with more aggressive disease too and a worse outcome .
The possible explanation is that most of the time obese men present with alteration of circulating levels of metabolic and sex steroid hormones, which are known to be involved in prostate development as well as oncogenesis .
Obesity, particularly when combined with physical inactivity, leads to the development of insulin resistance with reduced glucose uptake. That, in turn, leads to chronically elevated blood levels of insulin. Insulin is a hormone that promotes growth and proliferation, thus is reasonable to add it in the list of risk factors that promote prostate cancer initiation and/or progression . Additionally, adipose cells represent a source of inflammation as well as of macrophages in adipose, which releases inflammatory mediators . Three meta-analyses reported a modest but consistent association between obesity and prostate cancer incidence independently of BMI increase . Data from three national surveys in the US population reported that obesity is associated with more aggressive prostate cancer and higher mortality despite its lower incidence .
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Incidence Of Fatal Prostate Cancer In The Us And England
The normal probability plot of residuals for each country-specific ageperiodcohort model demonstrated overall good fit thus all models were suitable for between-country comparisons. Between 1995 and 2005, 11% of US men newly diagnosed with prostate cancer died from their disease within 10 years , compared with 17% of men diagnosed in England . In 1995, the US outpaced England 3-to-1 with an age-standardised fatal prostate cancer incidence rate of 85.8 per 100,000 . By 2005, the incidence rates of fatal prostate cancer between the two countries had switched owing to a 55% decline in the US and a corresponding 100% increase in England . In the US, the fatal prostate cancer incidence rate declined for each single age group , with the sharpest declines occurring among those aged 6069 years . By contrast, the EAPC for fatal prostate cancer incidence in England increased at every age , with the highest rate of increase observed among men aged 4549 years.
Table 1 Fatal prostate cancer incidence rates in the United States and England between 1995 and 2005, among men aged 4584 years.
Brca1 Or Brca2 Gene Changes
You might hear your doctor call these mutations. Youâre born with them, so they fall in the category of risk factors you canât control. They run in families, but they only affect a small number of people. They raise the odds of breast and ovarian cancers in women and prostate cancer in some men.
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Screening For Prostate Cancer In African American Men
Burden
In the United States, African American men are more likely to develop prostate cancer than white men . African American men are also more than twice as likely as white men to die of prostate cancer .1 The higher death rate is attributable in part to an earlier age at cancer onset, more advanced cancer stage at diagnosis, and higher rates of more aggressive cancer . These differences in death from prostate cancer may also reflect that African American men have lower rates of receiving high-quality care.
Available Evidence
The USPSTF searched for evidence about the potential benefits and harms of PSA-based screening for prostate cancer in African American men.
Potential Benefits
The PLCO trial enrolled 4% African American men, which is not enough to determine whether the overall trial results differed for African American men.17 The ERSPC trial did not record or report any race-specific subgroup information. The low proportion of persons of African descent in European countries during the study period makes it likely that these groups were not well represented.
Potential Harms
An analysis from the PLCO trial found that African American men were significantly more likely to have major infections after prostate biopsy than white men .13 Evidence is insufficient to compare the risk of false-positive results, potential for overdiagnosis, and magnitude of harms from prostate cancer treatment in African American vs other men.
Advising African American Men
Am I At Risk Of Prostate Cancer
In the UK, about 1 in 8 men will be diagnosed with prostate cancer in their lifetime. We dont know exactly what causes prostate cancer but there are some things that may mean you are more likely to get it these are called risk factors.
There are three main risk factors for getting prostate cancer, which are things you cant change. These are:
- getting older it mainly affects men aged 50 or over
If you have any of these risk factors or if you have any symptoms, speak to your GP. They can talk to you about your risk, and about the tests that are used to diagnose prostate cancer. You can also get in touch with our Specialist Nurses, who can help you understand your risk of prostate cancer.
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Recent Trends In Prostate Cancer Incidence By Age Cancer Stage And Grade The United States 20012007
1Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, CDC, 4770 Buford Hwy, MS K55, Atlanta, GA 30341, USA
2Department of Urology and Winship Cancer Institute, School of Medicine, Emory University, 1365C Clifton Road, Atlanta, GA 30322, USA
Academic Editor:
Abstract
1. Introduction
Prostate cancer is the most commonly diagnosed non-skin cancer and the second leading cause of cancer death among American men. Each year, approximately 220,000 men are diagnosed with prostate cancer and 29,000 die from it . With the introduction of the prostate-specific antigen testing in the mid-1980s, prostate cancer incidence rate increased drastically, at about 12% per year, and peaked in 1992 . The rate subsequently declined, at about 10% per year for the following three years and then appeared to stabilize from 1995 to 2005 . In 2011, Kohler et al. reported a stable trend of prostate cancer incidence from 1998 to 2007 however, demographic and clinical factors were not examined in this study . With the widespread use of the PSA test, the mean age at diagnosis dropped substantially, from 72.2 years between 1988-1989 to 67.2 years between 2004 and 2005 . Studies using Surveillance, Epidemiology, and End Results Program data have shown that the distribution of prostate cancer stage and grade has also dramatically changed, with localized and moderately differentiated tumors becoming predominant .
2. Patients and Methods
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Know Your Prostate Booklet
This booklet is a guide to the prostate what it is, what it does, and what can go wrong with it.
The following people have a prostate:
- non-binary people who were assigned male at birth**
- some intersex people.***
* A trans woman is someone who was assigned male at birth but identifies as a woman. Trans women can develop prostate problems, even if they have taken hormones. The prostate is not removed during genital reconstructive surgery.** A non-binary person may not identify as a man or a woman.*** An intersex person may have both male and female sexual characteristics and so might have a prostate.
Trans, non-binary or intersex?
The information on this website has been developed based on guidance and evidence in men. If you are a trans woman, male-assigned non-binary or intersex, some of this information is still relevant to you but your experience may be slightly different. Find out more about trans women and prostate cancer.
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Vitamin And Mineral Supplements
Vitamin D
An inverse relationship was observed between sunlight, or UVB exposure, and incidence of prostate cancer , suggesting that vitamin D deficiency might increase prostate cancer risk development . Similarly, discoveries were made by Barnett and Beer who found that people living in âsunnyâ countries were at lower risk of developing secondary solid cancer after melanoma compared to people living in âless sunnyâ countries.
The incidence of prostate cancer in African-American men is twice that of Caucasians, suggesting that race might play a role. There might be a role for vitamin D deficiency in this as UV radiation is blocked in darkly pigmented skin due to high melanin levels and this mechanism inhibits the conversion to vitamin D3 .
Vitamin E
Vitamin E is a vitamin which is fat soluble. Vegetable oils, egg yolks, and nuts are the important dietary sources of vitamin E. Tocopherols present in vitamin E have both potent cellular anti-oxidant with anticancer properties . Studies investigating the relationship between vitamin E and prostate cancer risk have shown contradicting results. The ATBC trial showed that in men who smoked supplementing daily vitamin E was not able to reduce the incidence of prostate cancer . In another large clinical trial , vitamin E supplementation did not show any benefit in 31,000 men with incident prostate cancer .
Selenium
Folate and vitamin B12
Patient Population Under Consideration
This recommendation applies to adult men in the general US population without symptoms or a previous diagnosis of prostate cancer. It also applies to men at increased risk of death from prostate cancer because of race/ethnicity or family history of prostate cancer. The sections below provide more information on how this recommendation applies to African American men and men with a family history of prostate cancer.
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Cases Of Aggressive Prostate Cancer On The Rise Research Finds
Cases of aggressive prostate cancer appear to be on the rise, researchers reported Tuesday.
The good news is its still rare for prostate cancer to spread. Just 3 percent of cases have already started spreading when men are diagnosed and prostate cancer overall has not become more common, the team found.
And the American Cancer Society strongly questioned the findings and the methods used to get them.
The researchers who were looking for evidence to support a return to widespread prostate cancer screening found that cases of metastatic prostate cancer the type that has started to spread in the body nearly doubled in men aged 55 to 69 since 2004. The reason is not yet clear.
One hypothesis is the disease has become more aggressive, regardless of the change in screening, said Dr. Edward Schaeffer, chair of urology at Northwestern University Feinberg School of Medicine and Northwestern Medicine, who led the study.
The other idea is since screening guidelines have become more lax, when men do get diagnosed, its at a more advanced stage of disease. Probably both are true. We dont know for sure, but this is the focus of our current work, Schaeffer continued.
One hypothesis is the disease has become more aggressive, regardless of the change in screening.
In 2012, the U.S. Preventive Services Task Force recommended against using a blood test called a prostate-specific antigen test to check most healthy men for prostate cancer.
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Prostate Cancer Incidence By Age
Prostate cancer incidence is strongly related to age, with the highest incidence rates being in older men. In the UK in 2016-2018, on average each year around a third of new cases were in males aged 75 and over.
Age-specific incidence rates rise steeply from around age 45-49, peak in the 75-79 age group before dropping slightly and remaining stable in the oldest age groups.The highest rates are in in the 75 to 79 age group.
Prostate cancer , Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Male Population, UK, 2016-2018
For prostate cancer, like most cancer types, incidence increases with age. This largely reflects cell DNA damage accumulating over time. Damage can result from biological processes or from exposure to risk factors. A drop or plateau in incidence in the oldest age groups often indicates reduced diagnostic activity perhaps due to general ill health.
The age distribution of prostate cancer cases probably partly reflects the age groups in which prostate specific antigen testing and transurethral resection of the prostate are carried out.
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Economics Cost Of Management Pc
From Europe and USA the costs of management of PC are as follows: in Italy from 6575.31 euro, in UK from 2818 pounds, and in France 12731 euro, and in USA from $12,000., , These costs are very high for low and low middle income countries. There have not been comparable figures from Africa. In Ghana, the head of Urology Unit in KBTH reports individual direct costs for radical prostatectomy or EBRT ranges from GH¢5000 6000 , for Brachytherapy the cost is GH¢30,000 GH¢32,000 i.e. 9000 Euros. For hormonal therapy the cost is from GH¢6400 12400 per year and for Orchidectomy the cost is GH¢2000 .
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Diagnostic Radiologic Procedure And Ultraviolet Light Exposure
The radiation generated from X-ray, CT and nuclear imaging is ionizing radiation that penetrates the tissue to reveal the bodyâs internal organs. However, ionizing radiation can damage DNA, and although cells repair most of the damage, sometimes small area may remain altered consequently leading to DNA mutations that may contribute to cancer development years down the road. The first study investigating the connection between low-dose ionization radiation from diagnostic X-ray procedures and risk for prostate cancer reported that exposure to a hip/pelvic X-ray significantly increased prostate cancer risk independently of other known risk factors such as family history of cancer . However, unless men were exposed to high doses of radiation during cancer treatment in youth, any increase in the risk for cancer due to medical radiation appears to be slight. Considering that the increase in high-dose imaging has occurred only since 1980 and the effects of radiation damage typically take many years to appear, this may explain the weak association between ionizing radiation and prostate cancer risk observed thus far.
Finally, exposure to solar UV radiation is inversely associated with both the incidence and mortality of prostate cancer . The biological explanation of this fact is based on the synthesis and physiological actions of vitamin D .
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