Prostate cancer risk factors

Prevention, risk, and screening answer different questions

Prevention asks whether something lowers the chance that cancer starts. Screening asks whether looking for cancer in a person without symptoms leads to less suffering or fewer deaths. Early detection is the hope behind screening. It is not proof that a cancer found today would have become dangerous, and it is not a diet.

The National Cancer Institute’s patient page on prevention is explicit about the limit: avoiding risk factors and supporting protective factors may lower risk, and it does not mean you will not get cancer. About one in eight men in the United States will be diagnosed. Most of those men do not die of the disease. The 2018 U.S. Preventive Services Task Force statement used a related pair of figures for its own review: about an 11 percent lifetime chance of diagnosis and about a 2.5 percent lifetime chance of dying of prostate cancer. The two sources are not required to match to the decimal. Both say diagnosis is much more common than death.

Risks you cannot choose

Age. Prostate cancer is uncommon before age 50, and the chance rises as men get older. The Task Force notes that the median age at death from prostate cancer is 80, and that more than two-thirds of those deaths are in men older than 75.

Family history. A father, brother, or son with prostate cancer raises risk above average. Some families also carry inherited syndromes. This page does not decide who should have genetic testing. That is a clinical conversation.

Race. Prostate cancer is more common in Black men than in White men, and Black men are more likely to die of it. The Task Force cited lifetime risks of dying of prostate cancer of about 4.2 percent for Black men, 2.9 percent for Hispanic men, 2.3 percent for White men, and 2.1 percent for Asian and Pacific Islander men, using the statistics available for the 2018 statement. Those gaps are not explained by a supplement.

What has looked harmful, helpful, or simply unclear

The National Cancer Institute’s patient summary groups the evidence this way. It is a summary for patients, not a personal prescription.

Vitamin E taken alone increased prostate-cancer diagnoses in the SELECT trial. The increase continued after men stopped the study capsules. Details are in the selenium article. This is a reason to be wary of high-dose vitamin E capsules, not a reason to fear vitamin E that occurs in ordinary food.

Folic acid supplements. In a 10-year study summarized by the National Cancer Institute, men who took 1 milligram folic acid supplements had a higher chance of prostate cancer, while men who got enough folate from food had a lower chance. Food folate and a supplement pill are not interchangeable in that finding.

Dairy foods and calcium. A diet high in dairy foods and calcium may be linked with a small increase in risk. The size of that link, and what any one man should do about bone health, are not settled by a single sentence. Do not drop calcium you were told to take for another condition because of this paragraph.

Finasteride and dutasteride. These prescription drugs lowered the number of prostate cancers found in large trials. They did not lower the number of deaths from prostate cancer in the finasteride trial, and it is not known whether either drug lowers deaths. They cause sexual side effects. This site does not recommend them as a prevention plan. The medicines article explains why a prevention headline is the wrong frame.

Selenium. SELECT did not show that selenium supplements lowered prostate-cancer risk. A 2014 analysis found that men who already had high selenium levels and then took selenium had a higher chance of high-grade cancer. More is not safer.

Diet, lycopene, and multivitamins. It is not known whether eating less fat or more fruits and vegetables lowers prostate-cancer risk or death. Lycopene supplements have not been shown to lower risk, even though some diet studies have found a link and others have not. Regular multivitamin use has not been shown to raise the risk of early cancer, but a large study found more advanced prostate cancer among men who took multivitamins more than seven times a week.

What to do with a risk you cannot erase

You can tell a clinician about your family history and ask whether a screening conversation should happen earlier than it would for an average-risk man. You can avoid high-dose vitamin E and selenium taken in the hope of preventing this cancer, because the best trial evidence goes the other way. You can treat smoking, weight, and activity as general health issues. The Task Force notes that smoking is associated with a higher risk of dying of prostate cancer, and that diet patterns have weaker and less consistent links. None of that is a guarantee about your future, and none of it replaces the screening tradeoffs described on the screening page.