Prostate cancer risk factors

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Overview

Common risk factors in the development of prostate cancer are dietary, lifestyle, family history, African-American men, occupational factors, age, environmental factors, and medication.

Risk Factors

Common risk factors in the development of prostate cancer include:

Genetic

Genetic background may contribute to prostate cancer risk, as suggested by associations with race, family, and specific gene variants. Men who have a first-degree relative (father or brother) with prostate cancer have twice the risk of developing prostate cancer, and those with two first-degree relatives affected have a fivefold greater risk compared with men with no family history.[1] In the United States, prostate cancer more commonly affects black men than white or Hispanic men, and is also more deadly in black men.[2][3] In contrast, the incidence and mortality rates for Hispanic men are one third lower than for non-Hispanic whites. Studies of twins in Scandinavia suggest that 40% of prostate cancer risk can be explained by inherited factors.[4]

No single gene is responsible for prostate cancer; many different genes have been implicated. Mutations in BRCA1 and BRCA2, important risk factors for ovarian cancer and breast cancer in women, have also been implicated in prostate cancer.[5] Other linked genes include the Hereditary Prostate cancer gene 1 (HPC1), the androgen receptor, and the vitamin D receptor.[2] TMPRSS2-ETS gene family fusion, specifically TMPRSS2-ERG or TMPRSS2-ETV1/4 promotes cancer cell growth.[6]

Two large genome-wide association studies linking single nucleotide polymorphisms (SNPs) to prostate cancer were published in 2008.[7][8] These studies identified several SNPs which substantially affect the risk of prostate cancer. For example, individuals with TT allele pair at SNP rs10993994 were reported to be at 1.6 times higher risk of prostate cancer than those with the CC allele pair. This SNP explains part of the increased prostate cancer risk of African American men as compared to American men of European descent, since the C allele is much more prevalent in the latter; this SNP is located in the promoter region of the MSMB gene, thus affects the amount of MSMB protein synthesized and secreted by epithelial cells of the prostate.[9]

Dietary

While some dietary factors have been associated with prostate cancer the evidence is still tentative.[10] Evidence supports little role for dietary fruits and vegetables in prostate cancer occurrence.[11] Red meat and processed meat also appear to have little effect in human studies.[12] Higher meat consumption has been associated with a higher risk in some studies.[13]

Lower blood levels of vitamin D may increase the risk of developing prostate cancer.[14]

Folic acid supplements have no effect on the risk of developing prostate cancer.[15]

Medication exposure

There are also some links between prostate cancer and medications, medical procedures, and medical conditions.[16] Use of the cholesterol-lowering drugs known as the statins may also decrease prostate cancer risk.[17]

Infection or inflammation of the prostate (prostatitis) may increase the chance for prostate cancer while another study shows infection may help prevent prostate cancer by increasing blood to the area. In particular, infection with the sexually transmitted infections chlamydia, gonorrhea, or syphilis seems to increase risk.[18] Finally, obesity[19] and elevated blood levels of testosterone[20] may increase the risk for prostate cancer. There is an association between vasectomy and prostate cancer however more research is needed to determine if this is a causative relationship.[21]

Research released in May 2007, found that US war veterans who had been exposed to Agent Orange had a 48% increased risk of prostate cancer recurrence following surgery.[22]

Infectious disease

An association with gonorrhea has been found, but a mechanism for this relationship has not been identified.[23]

In 2006, a previously unknown retrovirus, Xenotropic MuLV-related virus or XMRV, was associated with human prostate tumors,[24] but subsequent reports on the virus were contradictory,[25][26] and the original 2006 finding was instead due to a previously undetected contamination.[27] The journals Science and PlosONE both retracted XMRV related articles.[28][29]

Sexual factors

Several case-control studies have shown that having many lifetime sexual partners or starting sexual activity early in life substantially increases the risk of prostate cancer.[30][31][32]

While the available evidence is weak,[33] tentative results suggest that frequent ejaculation may decrease the risk of prostate cancer.[34] A study, over eight years, showed that those that ejaculated most frequently (over 21 times per month on average) were less likely to get prostate cancer.[35] The results were broadly similar to the findings of a smaller Australian study.[36]


References

  1. ↑ Steinberg GD, Carter BS, Beaty TH, Childs B, Walsh PC (1990). "Family history and the risk of prostate cancer". Prostate. 17 (4): 337–47. doi:10.1002/pros.2990170409. PMID 2251225.
  2. ↑ 2.0 2.1 Gallagher RP, Fleshner N (October 1998). "Prostate cancer: 3. Individual risk factors" (PDF). CMAJ. 159 (7): 807–13. PMC 1232741. PMID 9805030.
  3. ↑ Hoffman RM, Gilliland FD, Eley JW, Harlan LC, Stephenson RA, Stanford JL, Albertson PC, Hamilton AS, Hunt WC, Potosky AL (March 2001). "Racial and ethnic differences in advanced-stage prostate cancer: the Prostate Cancer Outcomes Study". J. Natl. Cancer Inst. 93 (5): 388–95. doi:10.1093/jnci/93.5.388. PMID 11238701.
  4. ↑ Lichtenstein P, Holm NV, Verkasalo PK, Iliadou A, Kaprio J, Koskenvuo M, Pukkala E, Skytthe A, Hemminki K (July 2000). "Environmental and heritable factors in the causation of cancer--analyses of cohorts of twins from Sweden, Denmark, and Finland". N. Engl. J. Med. 343 (2): 78–85. doi:10.1056/NEJM200007133430201. PMID 10891514.
  5. ↑ Struewing JP, Hartge P, Wacholder S, Baker SM, Berlin M, McAdams M, Timmerman MM, Brody LC, Tucker MA (May 1997). "The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews". N. Engl. J. Med. 336 (20): 1401–8. doi:10.1056/NEJM199705153362001. PMID 9145676.
  6. ↑ Beuzeboc P, Soulié M, Richaud P, Salomon L, Staerman F, Peyromaure M, Mongiat-Artus P, Cornud F, Paparel P, Davin JL, Molinié V (December 2009). "[Fusion genes and prostate cancer. From discovery to prognosis and therapeutic perspectives]". Prog. Urol. (in French). 19 (11): 819–24. doi:10.1016/j.purol.2009.06.002. PMID 19945666.
  7. ↑ Eeles RA, Kote-Jarai Z, Giles GG, Olama AA, Guy M, Jugurnauth SK, Mulholland S, Leongamornlert DA, Edwards SM, Morrison J, Field HI, Southey MC, Severi G, Donovan JL, Hamdy FC, Dearnaley DP, Muir KR, Smith C, Bagnato M, Ardern-Jones AT, Hall AL, O'Brien LT, Gehr-Swain BN, Wilkinson RA, Cox A, Lewis S, Brown PM, Jhavar SG, Tymrakiewicz M, Lophatananon A, Bryant SL, Horwich A, Huddart RA, Khoo VS, Parker CC, Woodhouse CJ, Thompson A, Christmas T, Ogden C, Fisher C, Jamieson C, Cooper CS, English DR, Hopper JL, Neal DE, Easton DF (March 2008). "Multiple newly identified loci associated with prostate cancer susceptibility". Nature Genetics. 40 (3): 316–21. doi:10.1038/ng.90. PMID 18264097.
  8. ↑ Thomas G, Jacobs KB, Yeager M, Kraft P, Wacholder S, Orr N, Yu K, Chatterjee N, Welch R, Hutchinson A, Crenshaw A, Cancel-Tassin G, Staats BJ, Wang Z, Gonzalez-Bosquet J, Fang J, Deng X, Berndt SI, Calle EE, Feigelson HS, Thun MJ, Rodriguez C, Albanes D, Virtamo J, Weinstein S, Schumacher FR, Giovannucci E, Willett WC, Cussenot O, Valeri A, Andriole GL, Crawford ED, Tucker M, Gerhard DS, Fraumeni JF, Hoover R, Hayes RB, Hunter DJ, Chanock SJ (March 2008). "Multiple loci identified in a genome-wide association study of prostate cancer". Nature Genetics. 40 (3): 310–5. doi:10.1038/ng.91. PMID 18264096.
  9. ↑ Whitaker HC, Kote-Jarai Z, Ross-Adams H, Warren AY, Burge J, George A, Bancroft E, Jhavar S, Leongamornlert D, Tymrakiewicz M, Saunders E, Page E, Mitra A, Mitchell G, Lindeman GJ, Evans DG, Blanco I, Mercer C, Rubinstein WS, Clowes V, Douglas F, Hodgson S, Walker L, Donaldson A, Izatt L, Dorkins H, Male A, Tucker K, Stapleton A, Lam J, Kirk J, Lilja H, Easton D, Cooper C, Eeles R, Neal DE (Oct 13, 2010). Vickers, Andrew, ed. "The rs10993994 risk allele for prostate cancer results in clinically relevant changes in microseminoprotein-beta expression in tissue and urine". PLoS ONE. 5 (10): e13363. doi:10.1371/journal.pone.0013363. PMC 2954177. PMID 20967219. open access publication – free to read
  10. ↑ Venkateswaran V, Klotz LH (Aug 2010). "Diet and prostate cancer: mechanisms of action and implications for chemoprevention". Nature Reviews Urology. 7 (8): 442–53. doi:10.1038/nrurol.2010.102. PMID 20647991.
  11. ↑ Key TJ (2011). "Fruit and vegetables and cancer risk". British journal of cancer. 104 (1): 6–11. doi:10.1038/sj.bjc.6606032. PMC 3039795. PMID 21119663. For other common cancers, including colorectal, breast and prostate cancer, epidemiological studies suggest little or no association between total fruit and vegetable consumption and risk.
  12. ↑ Alexander DD, Mink PJ, Cushing CA, Sceurman B (2010). "A review and meta-analysis of prospective studies of red and processed meat intake and prostate cancer". Nutrition journal. 9: 50. doi:10.1186/1475-2891-9-50. PMC 2987772. PMID 21044319.
  13. ↑ "Chemicals in Meat Cooked at High Temperatures and Cancer Risk". National Cancer Institute.
  14. ↑ Wigle DT, Turner MC, Gomes J, Parent ME (March 2008). "Role of hormonal and other factors in human prostate cancer". Journal of Toxicology and Environmental Health. Part B, Critical Reviews. 11 (3–4): 242–59. doi:10.1080/10937400701873548. PMID 18368555.
  15. ↑ Qin X, Cui Y, Shen L, Sun N, Zhang Y, Li J, Xu X, Wang B, Xu X, Huo Y, Wang X (Jan 22, 2013). "Folic acid supplementation and cancer risk: A meta-analysis of randomized controlled trials". International Journal of Cancer. Journal International Du Cancer. 133 (5): 1033–41. doi:10.1002/ijc.28038. PMID 23338728.
  16. ↑ Jacobs EJ, Rodriguez C, Mondul AM, Connell CJ, Henley SJ, Calle EE, Thun MJ (July 2005). "A large cohort study of aspirin and other nonsteroidal anti-inflammatory drugs and prostate cancer incidence". J. Natl. Cancer Inst. 97 (13): 975–80. doi:10.1093/jnci/dji173. PMID 15998950.
  17. ↑ Shannon J, Tewoderos S, Garzotto M, Beer TM, Derenick R, Palma A, Farris PE (August 2005). "Statins and prostate cancer risk: a case-control study". Am. J. Epidemiol. 162 (4): 318–25. doi:10.1093/aje/kwi203. PMID 16014776.
  18. ↑ Dennis LK, Lynch CF, Torner JC (July 2002). "Epidemiologic association between prostatitis and prostate cancer". Urology. 60 (1): 78–83. doi:10.1016/S0090-4295(02)01637-0. PMID 12100928.
  19. ↑ Calle EE, Rodriguez C, Walker-Thurmond K, Thun MJ (April 2003). "Overweight, obesity, and mortality from cancer in a prospectively studied cohort of U.S. adults". N. Engl. J. Med. 348 (17): 1625–38. doi:10.1056/NEJMoa021423. PMID 12711737.
  20. ↑ Gann PH, Hennekens CH, Ma J, Longcope C, Stampfer MJ (August 1996). "Prospective study of sex hormone levels and risk of prostate cancer". J. Natl. Cancer Inst. 88 (16): 1118–26. doi:10.1093/jnci/88.16.1118. PMID 8757191.
  21. ↑ "?". Retrieved 9 August 2010.
  22. ↑ "Veterans exposed to Agent Orange have higher rates of prostate cancer recurrence". Medical College of Georgia News. May 20, 2007.
  23. ↑ Invalid <ref> tag; no text was provided for refs named CainiGandini2014
  24. ↑ Urisman A, Molinaro RJ, Fischer N, Plummer SJ, Casey G, Klein EA, Malathi K, Magi-Galluzzi C, Tubbs RR, Ganem D, Silverman RH, DeRisi JL (March 2006). "Identification of a Novel Gammaretrovirus in Prostate Tumors of Patients Homozygous for R462Q RNASEL Variant". PLoS Pathog. 2 (3): e25. doi:10.1371/journal.ppat.0020025. PMC 1434790. PMID 16609730. open access publication – free to read
  25. ↑ Schlaberg R, Choe DJ, Brown KR, Thaker HM, Singh IR (September 2009). "XMRV is present in malignant prostatic epithelium and is associated with prostate cancer, especially high-grade tumors". Proc. Natl. Acad. Sci. U.S.A. 106 (38): 16351–6. doi:10.1073/pnas.0906922106. PMC 2739868. PMID 19805305.
  26. ↑ Hohn O, Krause H, Barbarotto P, Niederstadt L, Beimforde N, Denner J, Miller K, Kurth R, Bannert N (2009). "Lack of evidence for xenotropic murine leukemia virus-related virus (XMRV) in German prostate cancer patients". Retrovirology. 6: 92. doi:10.1186/1742-4690-6-92. PMC 2770519. PMID 19835577.
  27. ↑ Lee D, Das Gupta J, Gaughan C, Steffen I, Tang N, Luk KC, Qiu X, Urisman A, Fischer N, Molinaro R, Broz M, Schochetman G, Klein EA, Ganem D, Derisi JL, Simmons G, Hackett J, Silverman RH, Chiu CY (2012). Tachedjian, Gilda, ed. "In-Depth Investigation of Archival and Prospectively Collected Samples Reveals No Evidence for XMRV Infection in Prostate Cancer". PLoS ONE. 7 (9): e44954. doi:10.1371/journal.pone.0044954. PMC 3445615. PMID 23028701. open access publication – free to read
  28. ↑ Alberts B (Dec 23, 2011). "Retraction". Science. 334 (6063): 1636. doi:10.1126/science.334.6063.1636-a. PMID 22194552. open access publication – free to read
  29. ↑ Ross, Susan, ed. (September 2012). "Retraction. Identification of a novel gammaretrovirus in prostate tumors of patients homozygous for R462Q RNASEL variant". PLoS Pathogens. 8 (9): 10.1371/annotation/7e2efc01–2e9b–4e9b–aef0–87ab0e4e4732. doi:10.1371/annotation/7e2efc01-2e9b-4e9b-aef0-87ab0e4e4732. PMC 3445601. PMID 23028303. open access publication – free to read
  30. ↑ Dennis LK, Dawson DV (January 2002). "Meta-analysis of measures of sexual activity and prostate cancer". Epidemiology (Cambridge, Mass.). 13 (1): 72–9. doi:10.1097/00001648-200201000-00012. PMID 11805589.
  31. ↑ Rosenblatt KA, Wicklund KG, Stanford JL (Jun 15, 2001). "Sexual factors and the risk of prostate cancer". American Journal of Epidemiology. 153 (12): 1152–8. doi:10.1093/aje/153.12.1152. PMID 11415949.
  32. ↑ Sarma AV, McLaughlin JC, Wallner LP, Dunn RL, Cooney KA, Schottenfeld D, Montie JE, Wei JT (September 2006). "Sexual behavior, sexually transmitted diseases and prostatitis: the risk of prostate cancer in black men". The Journal of Urology. 176 (3): 1108–13. doi:10.1016/j.juro.2006.04.075. PMID 16890703.
  33. ↑ Male Reproductive Cancers. Springer New York. 2010. p. 27. ISBN 9781441904508.
  34. ↑ Scardino, Peter (2005). Comprehensive textbook of genitourinary oncology (3rd ed.). Philadelphia: Lippincott Williams & Wilkins. p. 16. ISBN 9780781749848.
  35. ↑ Leitzmann, MF; Platz, EA; Stampfer, MJ; Willett, WC; Giovannucci, E (7 April 2004). "Ejaculation frequency and subsequent risk of prostate cancer". JAMA. 291 (13): 1578–86. doi:10.1001/jama.291.13.1578. PMID 15069045.
  36. ↑ Giles, GG; Severi, G; English, DR; McCredie, MR; Borland, R; Boyle, P; Hopper, JL (August 2003). "Sexual factors and prostate cancer". BJU international. 92 (3): 211–6. doi:10.1046/j.1464-410x.2003.04319.x. PMID 12887469.

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