Prostate Cancer: Risk Factors and Prevention

Approved by the Cancer.Net Editorial Board, 12/2022

ON THIS PAGE: You will find out more about the factors that increase the chance of developing prostate cancer. Use the menu to see other pages.

A risk factor is anything that increases a person’s chance of developing cancer. Although risk factors often influence the chance to develop cancer, most do not directly or by themselves cause cancer. Some people with several known risk factors never develop cancer, while others with no known risk factors do. Knowing your risk factors and talking about them with your doctor may help you make more informed lifestyle and health care choices.

The following factors may raise a person's risk of developing prostate cancer:

  • Age. The risk of prostate cancer increases with age, especially after age 50. Around 60% of prostate cancers are diagnosed in people who are 65 or older. Older adults who are diagnosed with prostate cancer can face unique challenges, specifically with regard to cancer treatment. For more information, please visit Cancer.Net’s section about aging and cancer.

  • Race. Black men in the United States, and other men of African ancestry, are diagnosed with prostate cancer more than men of other races. Black men are more likely to die from prostate cancer than White men.

  • North American or northern European location. Prostate cancer occurs most often in North America and northern Europe. It also appears that prostate cancer is increasing among Asian people living in urbanized environments, such as Hong Kong, Singapore, and North American and European cities, particularly among those who have a lifestyle with less physical activity and a less healthy diet.

  • Family history. Prostate cancer that runs in a family, called familial prostate cancer, makes up about 20% of all prostate cancers. This type of prostate cancer develops because of a combination of shared genes and shared environmental or lifestyle factors.

    Hereditary prostate cancer, which is inheriting the risk from a relative, is rare and accounts for about 5% of all cases. Hereditary prostate cancer occurs when changes in genes, or mutations, are passed down within a family from 1 generation to the next. This is called a germline mutation. If someone has a first-degree relative—meaning a parent, sibling, or child—with prostate cancer, their risk of developing prostate cancer is 2 to 3 times higher than the average risk. This risk increases even further with the number of relatives diagnosed with prostate cancer.

    Hereditary prostate cancer may be suspected if a family history includes any of the following characteristics:

    • 3 or more first-degree relatives with prostate cancer

    • Prostate cancer in 3 generations on the same side of the family

    • 2 or more close relatives, such as a parent, sibling, child, grandparent, uncle, or nephew, on the same side of the family diagnosed with prostate cancer before age 55

  • Hereditary breast and ovarian cancer (HBOC) syndrome. HBOC is associated with germline, or inherited, DNA-repair mutations to the BRCA1 and/or BRCA2 genes. BRCA stands for “BReast CAncer.” HBOC is most commonly associated with an increased risk of breast and ovarian cancers in women. However, men with HBOC also have an increased risk of developing breast cancer and a more aggressive form of prostate cancer. Mutations in the BRCA1 and BRCA2 genes are thought to cause only a small percentage of inherited prostate cancers. Those who have BRCA1 or BRCA2 mutations should consider screening for prostate cancer at an earlier age. Genetic testing may only be appropriate for families with prostate cancer that may also have HBOC. If you are concerned about this based on your own family history, please talk with a genetic counselor or doctor for more information.

  • Other genetic changes. Other genes that may carry an increased risk of developing prostate cancer include HPC1, HPC2, HPCX, CAPB, ATM, FANCA, HOXB13, and mismatch repair genes. However, none of them has been directly shown to cause prostate cancer or be specific to this disease. Research to identify genes associated with an increased risk of prostate cancer is ongoing, and researchers are constantly learning more about how specific genetic changes can influence the development of prostate cancer. At present, there are no genetic tests available to determine someone's chance of developing prostate cancer.

  • Agent Orange exposure. The U.S. Department of Veterans Affairs (VA) lists prostate cancer as a disease associated with exposure to Agent Orange, a chemical used during the Vietnam War. If you are a veteran who may have been exposed to Agent Orange, please talk to your doctor in the VA system. Learn more about the link with Agent Orange in this article

  • Eating habits and weight. No study has proven that diet and nutrition can directly cause or prevent the development of prostate cancer. However, many studies that look at links between certain eating behaviors and cancer suggest there may be a connection. For example, obesity is associated with many cancers, including prostate cancer, and a healthy diet to avoid weight gain is recommended (see “Dietary changes” below).

Prevention

Different factors cause different types of cancer. Researchers continue to look into what factors cause prostate cancer, including ways to prevent it. Although there is no proven way to completely prevent prostate cancer, you may be able to lower your risk. Talk with your health care team for more information about your personal risk of cancer.

Chemoprevention

A class of drugs called 5-alpha-reductase inhibitors (5-ARIs), which includes dutasteride (Avodart) and finasteride (Proscar), are often used to treat benign prostatic hypertrophy (BPH). They may also lower the risk of developing prostate cancer. Some previous clinical trials suggested that 5-ARIs were linked to more aggressive prostate cancers, but newer studies have suggested that this is not true. According to the results of a long-term follow-up study published in 2013, 78% of people either taking finasteride or a placebo were still alive 15 years later. These results suggest that taking finasteride does not lower the risk of death for those with prostate cancer. The U.S. Food and Drug Administration (FDA) has not approved these drugs for the prevention of prostate cancer. However, a 5-ARI is approved by the FDA for the treatment of lower urinary tract symptoms associated with BPH.

The decision to take a 5-ARI is different for each person. Anyone considering taking this class of medication should discuss the possible benefits and side effects with their doctor.

Dietary changes

There is not enough information right now to make clear recommendations about the exact role eating behaviors play in prostate cancer. Dietary changes may need to be made many years earlier in a person’s life to reduce the risk of developing prostate cancer later in life.

Here is a brief summary of the current research:

  • In some studies, regularly eating foods high in fat, especially animal fat, has been associated with increased prostate cancer risk. However, no prospective studies have yet proven that diets high in animal fat raise the risk of prostate cancer. Prospective studies look at people who follow either high-fat or low-fat diets and then measure the total number of people in each group who are diagnosed with prostate cancer. 

  • A diet high in vegetables, fruits, and legumes, such as beans and peas, may lower the risk of prostate cancer. It is unclear which nutrients are directly responsible. Although lycopene, a nutrient found in tomatoes and other vegetables, has been shown to be associated with a lower risk of prostate cancer, the data have not proven that there is a relationship between lycopene and preventing cancer.

  • Currently no specific vitamins, minerals, or other supplements have been shown in clinical trials to prevent prostate cancer. Talk with your doctor before taking any supplements to prevent prostate cancer.

  • Specific changes to eating behaviors may not stop or slow the development of prostate cancer. It is possible such changes would need to be made early in life to have an effect.

The next section in this guide is Screening. It explains how tests may find cancer before signs or symptoms appear. Use the menu to choose a different section to read in this guide.