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Risk factors for prostate cancer
Last reviewed: 07.07.2025
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[ Genetic risk factors for prostate cancer
In case of prostate cancer (PCa) in close relatives, the risk of developing the disease increases at least twice, if two or more relatives are ill - 5-11 times. About 9% of cases of PCa are true hereditary prostate cancer. It is probable if PCa was in three or more relatives or in two relatives under the age of 55.
According to autopsy data, the prevalence of the disease is approximately the same throughout the world. At the same time, the incidence varies in different countries: in the USA and Northern Europe it is much higher than in Southeast Asia. However, the incidence of the disease increases among the Japanese living in Hawaii, and among those living in California it is close to that of the Americans. Judging by these data, certain environmental factors play a role in the transition from latent to clinically manifested cancer. At the same time, mutations of the p53 gene are found much less often in the Japanese than in Europeans and Americans. In addition, mutations of androgen receptors in latent prostate cancer are encountered less often than in clinically manifested disease.
Given the high prevalence of prostate cancer, it is necessary to study the factors initiating the transformation of latent cancer into clinically significant forms and to develop measures to prevent this process.
Poor lifestyle is the main risk factor for prostate cancer
Possibly, excess animal fats in the niche, deficiency of vitamin E, selenium, lignans and isoflavones, protective effect of sunlight (increased formation of vitamin D) are important. The most probable and best studied factor increasing the risk of prostate cancer is the consumption of fatty foods and, to a lesser extent, "red" meat. The effect of smoking has not been clearly established, but in long-term and heavy smokers, prostate cancer proceeds more aggressively. According to the study by Giovannucci E. et al. (1999), the risk of developing cancer in men who smoke more than one pack of cigarettes daily for ten years is 85% higher, and the risk of death from prostate cancer is 200% higher compared to non-smokers. However, no significant difference in morbidity and mortality rates was found between these two groups. Hickey et al. (2001) studied possible biological mechanisms that explain the relationship between smoking and prostate cancer: the damaging effect of cadmium contained in tobacco; changes in hormonal levels; immune suppression; gene mutations (e.g., p53). Thus, smoking can be considered a risk factor for prostate cancer and its aggressive course.
There is currently no data on the effect of alcohol on the development of prostate cancer. It is known that red wine, due to its content of resveratrol, has a protective effect on prostate cells.
Recently, studies have been conducted on micro- and macroelements included in the normal diet to find factors that can change or reduce the risk of prostate cancer. According to two randomized studies, daily intake of selenium at a dose of 200 mg and vitamin E at 50 mg was associated with a 52% and 36% reduction in the risk of developing prostate cancer, respectively. The SELECT (Selenium and Vitamin E Prostate Cancer Prevention Trial) study, which is studying the effectiveness of selenium and vitamin E as chemoprophylactic agents, will be completed by 2013.
Many studies have been devoted to the study of the effectiveness of drugs that affect androgen status (3a-reductase inhibitors), fat metabolism (statins) and inflammation (non-steroidal anti-inflammatory drugs). Since androgens are involved in the pathogenesis of prostate cancer, 5a-reductase inhibitors can reduce the risk of developing the disease by 25%, but this increases the proportion of poorly differentiated cancer. At present, these drugs cannot be recommended for the chemoprophylaxis of prostate cancer. The effect of non-steroidal anti-inflammatory drugs (NSAIDs) and statins on the risk of developing prostate cancer has not been clearly proven, so their widespread use for chemoprophylaxis is also not recommended.
Thus, hereditary factors play the most important role in the pathogenesis of prostate cancer, and environmental factors influence its development.