Prostate cancer risk factors

Prostate cancer is not clearly linked to any preventable risk factors.[1,2]

Prostate Cancer Risk Factors

Increases risk ('sufficient' or 'convincing' evidence) May increase risk ('limited' or 'probable' evidence) Decreases risk ('sufficient' or 'convincing' evidence) May decrease risk ('limited' or 'probable' evidence)
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  • Androgenic (anabolic) steroids
  • Arsenic (and compounds)
  • Cadmium (and compounds)
  • Working in rubber production
  • Thorium-232 (and decay products)
  • X-radiation, gamma radiation
  • Body fatness (advanced prostate cancer)
  • Adult attained height
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International Agency for Research on Cancer (IARC) and World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) classifications. Find out more about IARC and WCRF/AICR classifications.

Use our interactive tool to explore risk factors for p[rostate cancer.

More information about cancer risk factors evidence

References

  1. Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl Cancer Inst 2011;103:1827-39.
  2. World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR). Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR; 2007.
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Inherited factors explain around 5–9% of prostate cancers, it is estimated.[1] A mix of genetic/biological factors and increased diagnostic activity in affected families may underpin the familial risk. Prostate cancer risk is not associated with prostate cancer in an adoptive parent (supporting a genetic link hypothesis),[2] but it is higher sooner rather than later after diagnosis in a family member, (supporting an increased diagnostic activity hypothesis),[3] cohort studies have shown.

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Prostate cancer risk is 2.1-2.4 times higher in men whose father has/had the disease, meta-analyses have shown.[1-3] Prostate cancer risk is 2.9-3.3 times higher in men whose brother has/had the disease, meta-analyses have shown.[1-3] Prostate cancer risk is 1.9 times higher in men with a second-degree relative (grandfather, uncle, nephew, or half-sibling) who has/had the disease, a meta-analysis has shown.[2]

Familial prostate cancer risk is higher in men aged under 65 compared with older men, and in men with more than one affected first-degree relative or with an affected relative diagnosed aged younger than 60.[2-4]

Prostate cancer risk is 19-24% higher in men whose mother has/had breast cancer, cohort studies have shown.[4,5] Prostate cancer risk is not associated with breast cancer in a sister.[4,5]

References

  1. Bruner DW, Moore D, Parlanti A, et al. Relative risk of prostate cancer for men with affected relatives: systematic review and meta-analysis. Int J Cancer 2003;107:797-803.
  2. Johns LE, Houlston RS. A systematic review and meta-analysis of familial prostate cancer risk. BJU Int 2003;91:789-94.
  3. Kicinski M, Vangronsveld J, Nawrot TS. An epidemiological reappraisal of the familial aggregation of prostate cancer: a meta-analysis. PLoS One 2011;6:e27130.
  4. Hemminki K, Chen B. Familial association of prostate cancer with other cancers in the Swedish Family-Cancer Database. Prostate 2005;65:188-94.
  5. Chen YC, Page JH, Chen R, et al. Family history of prostate and breast cancer and the risk of prostate cancer in the PSA era. Prostate 2008;68:1582-91.
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Prostate cancer risk is up to 5 times higher in men with BRCA2 Open a glossary item mutation compared with the general population, a cohort study showed.[1] Prostate cancer risk among men under 65 years old is more than 7 times higher in those with BRCA2 mutation compared with the general population, a cohort study showed.[1]

Prostate cancer risk may be higher in men with BRCA1 Open a glossary item mutation, but evidence remains unclear.[2-4]

Prostate cancer risk may be increased with several other genetic variants; research is ongoing.[5-12]

References

  1. Cancer risks in BRCA2 mutation carriers. The Breast Cancer Linkage Consortium. J Natl Cancer Inst 1999;91:1310-6.
  2. Thompson D, Easton DF. Cancer Incidence in BRCA1 mutation carriers. J Natl Cancer Inst 2002;94:1358-65.
  3. Fachal L, Gomez-Caamano A, Celeiro-Munoz C, et al. BRCA1 mutations do not increase prostate cancer risk: results from a meta-analysis including new data. Prostate 2011;71:1768-79.
  4. Leongamornlert D, Mahmud N, Tymrakiewicz M, et al. Germline BRCA1 mutations increase prostate cancer risk. Br J Cancer. 2012;106(10):1697-701.
  5. Damber JE, Aus G. Prostate cancer. Lancet 2008;371:1710-21.
  6. Eeles RA, Kote-Jarai Z, Giles GG, et al. Multiple newly identified loci associated with prostate cancer susceptibility. Nat Genet 2008;40:316-21.
  7. Amundadottir LT, Sulem P, Gudmundsson J, et al. A common variant associated with prostate cancer in European and African populations. Nat Genet 2006;38:652-8.
  8. Thomas G, Jacobs KB, Yeager M, et al. Multiple loci identified in a genome-wide association study of prostate cancer. Nat Genet 2008;40:310-5.
  9. Zheng SL, Sun J, Cheng Y, et al. Association between two unlinked loci at 8q24 and prostate cancer risk among European Americans. J Natl Cancer Inst 2007;99:1525-33.
  10. Haiman CA, Le Marchand L, Yamamato J, et al. A common genetic risk factor for colorectal and prostate cancer. Nat Genet 2007;39:954-6.
  11. Gudmundsson J, Sulem P, Rafnar T, et al. Common sequence variants on 2p15 and Xp11.22 confer susceptibility to prostate cancer. Nat Genet 2008;40:281-3.
  12. Camp NJ, Cannon-Albright LA, Farnham JM, et al. Compelling evidence for a prostate cancer gene at 22q12.3 by the International Consortium for Prostate Cancer Genetics. Hum Mol Genet 2007;16:1271-8.
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Prostate cancer risk is 2.1-4.9 times higher in men with Lynch syndrome, compared with the general population, a meta-analysis and cohort study have shown.[1,2]

References

  1. Ryan S, Jenkins MA, Win AK. Risk of Prostate Cancer in Lynch Syndrome: A Systematic Review and Meta-analysis. Cancer Epidemiol Biomarkers Prev. 2014;23(3):437-49.
  2. Haraldsdottir S, Hampel H, Wei L, et al. Prostate cancer incidence in males with Lynch syndrome. Genet Med. 2014.
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Prostate cancer risk is 38-83% higher in men with the highest levels of insulin-like growth factor-1 (IGF-1), meta- and pooled analyses have shown.[1,2] Prostate cancer risk is not associated with insulin-like growth factor-2 (IGF-2) levels, meta- and pooled analyses have shown.[2,3]

Prostate cancer risk is generally not associated with insulin-like growth factor binding protein (IGFBP) levels, meta- and pooled analyses have shown; this may vary between IGFBPs.[2,3]

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Androgenic (anabolic) steroids – which have similar effects to testosterone in the body – are classified by the International Agency for Research on Cancer (IARC) as a probable cause of prostate cancer, based on limited evidence.[1]

Prostate cancer treatment can involve use of medicines or surgery to reduce testosterone levels, as prostate tumours rely on testosterone to grow.

References

  1. Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl Cancer Inst 2011;103:1827-39.
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Greater adult attained height (as a marker of factors affecting linear growth) is classified by the World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR) as a probable cause of prostate cancer.[1]

Risk of advanced, aggressive, or fatal prostate cancer is 12% higher per 10cm height increment, a meta-analysis has shown.[2] Overall prostate cancer risk is 5% higher per 5cm height increment, a pooled analysis of Nordic data showed.[3]

References

  1. World Cancer Research Fund. Diet, Nutrition, Physical Activity and Prostate Cancer .WCRF:London;2014.
  2. Zuccolo L, Harris R, Gunnell D, et al. Height and prostate cancer risk: a large nested case-control study (ProtecT) and meta-analysis. Cancer Epidemiol Biomarkers Prev 2008;17:2325-36.
  3. Wiren S, Haggstrom C, Ulmer H, et al. Pooled cohort study on height and risk of cancer and cancer death. Cancer Causes Control. 2013.
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Prostate cancer risk is higher in men with previous kidney,[1-4] bladder,[4-8] lung,[9] or thyroid[4,10] cancers, or melanoma,[3,11-14] cohort studies have shown.

References

  1. Liu H, Hemminki K, Sundquist J. Renal cell carcinoma as first and second primary cancer: etiological clues from the Swedish Family-Cancer Database. J Urol 2011;185:2045-9.
  2. Neuzillet Y, Lechevallier E, Coulange C. Renal cancer and second cancer: critical review of the literature. Prog Urol 2007;17:35-40.
  3. Zhang H, Bermejo JL, Sundquist J, et al. Prostate cancer as a first and second cancer: effect of family history. Br J Cancer 2009;101:935-9.
  4. Jégu J, Colonna M, Daubisse-Marliac L, et al. The effect of patient characteristics on second primary cancer risk in France. BMC Cancer. 2014;14:94.
  5. Zhang H, Bermejo JL, Sundquist J, et al. Prostate cancer as a first and second cancer: effect of family history. Br J Cancer 2009;101:935-9.
  6. Lehnert M, Kraywinkel K, Pesch B, et al. New malignancies following cancer of the urinary bladder: analysis of German cancer registry data. Eur J Cancer Care (Engl) 2012;21:398-402.
  7. Kellen E, Zeegers MP, Dirx M, et al. Occurrence of both bladder and prostate cancer in five cancer registries in Belgium, The Netherlands and the United Kingdom. Eur J Cancer 2007;43:1694-700.
  8. Hayat MJ, Howlader N, Reichman ME, et al. Cancer statistics, trends, and multiple primary cancer analyses from the Surveillance, Epidemiology, and End Results (SEER) Program. Oncologist 2007;12:20-37.
  9. Chuang SC, Scelo G, Lee YC, et al. Risks of second primary cancer among patients with major histological types of lung cancers in both men and women. Br J Cancer 2010;102:1190-5.
  10. Subramanian S, Goldstein DP, Parlea L, et al. Second primary malignancy risk in thyroid cancer survivors: a systematic review and meta-analysis. Thyroid 2007;17:1277-88.
  11. Bradford PT, Freedman DM, Goldstein AM, et al. Increased risk of second primary cancers after a diagnosis of melanoma. Arch Dermatol 2010;146:265-72.
  12. Kok DE, van de Schans SA, Liu L, et al. Risk of prostate cancer among cancer survivors in the Netherlands. Cancer Epidemiol 2012.
  13. Scelo G, Boffetta P, Autier P, et al. Associations between ocular melanoma and other primary cancers: an international population-based study. Int J Cancer 2007;120:152-9.
  14. Youlden DR, Baade PD. The relative risk of second primary cancers in Queensland, Australia: a retrospective cohort study. BMC Cancer. 2011;11:83.
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Thorium-232 and its decay products, X radiation, and gamma radiation are classified by the International Agency for Research on Cancer (IARC) as probable causes of prostate cancer, based on limited evidence.[1]

Prostate cancer risk is higher in atomic bomb survivors compared with the general population, a cohort study has shown.[2]

References

  1. Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl Cancer Inst 2011;103:1827-39.
  2. Preston DL, Ron E, Tokuoka S, et al. Solid cancer incidence in atomic bomb survivors: 1958-1998. Radiat Res 2007;168:1-64.
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Cadmium and cadmium compounds are classified by the International Agency for Research on Cancer (IARC) as probable causes of prostate cancer, based on limited evidence.[1] Cadmium is found in tobacco smoke, but food is the main exposure source in non-smokers.

Prostate cancer risk is 14% higher in men with the highest dietary cadmium intake, versus those with the lowest, a meta-analysis showed.[2]

References

  1. World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR). Food, Nutrition, Physical Activity, and the Prevention of Cancer: a Global Perspective. Washington DC: AICR; 2007.
  2. Julin B, Wolk A, Johansson JE, et al. Dietary cadmium exposure and prostate cancer incidence: a population-based prospective cohort study. Br J Cancer 2012;107:895-900.
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Prostate cancer risk is 14% higher in men with the highest blood folate levels, versus those with the lowest, a meta-analysis showed;[1] however a previous meta-analysis showed no association.[2]

Prostate cancer risk is 24% higher in men taking folic acid supplements, versus those not, a meta-analysis of Randomised controlled trails (RCTs) showed;[3] however a previous meta-analysis showed no association.[4] Prostate cancer risk is not associated with dietary folate intake, a meta-analysis showed.[1]

References

  1. Tio M, Andrici J, Cox MR, Eslick GD. Folate intake and the risk of prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2014;17(3):213-9.
  2. Collin SM, Metcalfe C, Refsum H, et al. Circulating folate, vitamin B12, homocysteine, vitamin B12 transport proteins, and risk of prostate cancer: a case-control study, systematic review, and meta-analysis. Cancer Epidemiol Biomarkers Prev 2010;19:1632-42. http://www.ncbi.nlm.nih.gov/pubmed/20501771.
  3. Wien TN, Pike E, Wisloff T, et al. Cancer risk with folic acid supplements: a systematic review and meta-analysis. BMJ Open 2012;2:e000653.
  4. Qin X, Cui Y, Shen L, et al. Folic acid supplementation and cancer risk: A meta-analysis of randomized controlled trials. Int J Cancer 2013.
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Prostate cancer risk is 60-80% higher in men with prostatitis (inflammation of the prostate) compared with healthy controls, meta-analyses of case-control studies have shown.[1,2] This may reflect increased investigative activity around the time of prostatitis diagnosis, or men with prostate cancer being more likely than men without it to recall prostatitis;[2] no association between prostatitis and prostate cancer was found in a cohort study.[3]

References

  1. Dennis LK, Lynch CF, Torner JC. Epidemiologic association between prostatitis and prostate cancer. Urology 2002;60:78-83.
  2. Jiang J, Li J, Yunxia Z, et al. The role of prostatitis in prostate cancer: meta-analysis. PLoS One. 2013;8(12):e85179.
  3. Tio M, Andrici J, Cox MR, Eslick GD. Folate intake and the risk of prostate cancer: a systematic review and meta-analysis. Prostate Cancer Prostatic Dis 2014;17(3):213-9.
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Prostate cancer risk is 10% higher in men who have had a vasectomy compared with men who have not, a cohort study has shown.[1] Meta-analysis results are inconsistent, and confounding (especially by PSA screening) is possible.[2,3]

References

  1. Siddiqui MM, Wilson KM, Epstein MM, et al. Vasectomy and Risk of Aggressive Prostate Cancer: A 24-Year Follow-Up Study. J Clin Oncol 2014.
  2. Tang LF, Jiang H, Shang XJ, et al. Vasectomy not associated with prostate cancer: a meta-analysis. Zhonghua Nan Ke Xue 2009;15:545-50.
  3. Dennis LK, Dawson DV, Resnick MI. Vasectomy and the risk of prostate cancer: a meta-analysis examining vasectomy status, age at vasectomy, and time since vasectomy. Prostate Cancer Prostatic Dis 2002;5:193-203.
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Arsenic (and inorganic arsenic compounds) and working in rubber production are classified by the International Agency for Research on Cancer (IARC) as probable causes of prostate cancer, based on limited evidence.[1]

Prostate cancer risk is 13-24% higher in men occupationally exposed to pesticides, compared with the general population, meta-analyses have shown.[2-4]

References

  1. Cogliano VJ, Baan R, Straif K, et al. Preventable exposures associated with human cancers. J Natl Cancer Inst 2011;103:1827-39.
  2. Van Maele-Fabry G, Libotte V, Willems J, et al. Review and meta-analysis of risk estimates for prostate cancer in pesticide manufacturing workers. Cancer Causes Control 2006;17:353-73.
  3. Van Maele-Fabry G, Willems JL. Prostate cancer among pesticide applicators: a meta-analysis. Int Arch Occup Environ Health 2004;77:559-70.
  4. Van Maele-Fabry G, Willems JL. Occupation related pesticide exposure and cancer of the prostate: a meta-analysis. Occup Environ Med 2003;60:634-42.
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Body fatness is classified by the World Cancer Research Fund / American Institute for Cancer Research (WCRF/AICR) as a probable cause of advanced prostate cancer.[1]

Advanced prostate cancer risk is 9-50% higher per 5-unit body mass index (BMI) increment, meta-analyses of cohort studies have shown.[2,3] This reflects increased likelihood of higher-BMI men being diagnosed at an advanced rather than an early stage, not an increased likelihood of them developing prostate cancer overall.[2,3]

Overweight and obesity may be associated with later-stage diagnosis because hormonal factors in excess body weight promote cancer development, or because excess body weight creates technical difficulties in diagnosis and treatment.[3]

Prostate cancer risk may be 30% higher in men in Europe with metabolic syndrome (characterised by overweight/obesity, ineffective insulin use, diabetes and hypertension), a meta-analysis showed; this may be mainly linked to hypertension and abdominal obesity.[4]

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Prostate cancer risk is lower in men with the highest intakes of the following foods and supplements, versus those with the lowest, meta- and pooled analyses, systematic reviews or cohort studies have shown:

  • Carrots – 18% lower risk.[1]
  • Soy – 48% lower risk (Asian populations only).[2,3]
  • Blood total carotenoid levels (advanced prostate cancer) – 65% lower risk (though may reflect increased likelihood of early-stage diagnosis).[REF:4]

References

  1. Xu X, Cheng Y, Li S, et al. Dietary carrot consumption and the risk of prostate cancer. Eur J Nutr. 2014.
  2. Yan L, Spitznagel EL. Soy consumption and prostate cancer risk in men: a revisit of a meta-analysis. Am J Clin Nutr 2009;89:1155-63.
  3. Hwang YW, Kim SY, Jee SH, et al. Soy food consumption and risk of prostate cancer: a meta-analysis of observational studies. Nutr Cancer 2009;61:598-606.
  4. Key TJ, Appleby PN, Allen NE, et al. Plasma carotenoids, retinol, and tocopherols and the risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition study. Am J Clin Nutr 2007;86:672-81.
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Prostate cancer risk is lower in men with the highest levels of the following behaviours, versus those with the lowest, meta- and pooled analyses, systematic reviews or cohort studies have shown:

  • Physical activity – 19% lower risk (no association with recreational physical activity, or in men aged 65+)[1]

References

  1. Liu Y, Hu F, Li D, et al. Does physical activity reduce the risk of prostate cancer? A systematic review and meta-analysis. Eur Urol 2011;60:1029-44.
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Prostate cancer risk is lower in men with the following medical conditions or using the following treatments, meta- and pooled analyses, systematic reviews or cohort studies have shown:

  • Diabetes – 15-28% lower risk[1-3] (no variation by diabetes treatment type[4-8])
  • Systemic lupus erythematosus Open a glossary item – up to a third lower risk.[9,10]
  • Human immunodeficiency virus (HIV) – 30-31% lower risk,[11,12] does not appear to be explained by increased PSA testing in HIV-positive men.[13]
  • Parkinson’s disease – 20% lower risk.[14]
  • Paracetamol (aggressive prostate cancer) – 38% lower risk with 30+ pills per month for 5+ years risk (though may reflect increased likelihood of early-stage diagnosis).[15]
  • Aspirin – 8-14% lower risk in users versus non-users, stronger effect for longer-term use and for advanced prostate cancer;[16,17] unclear association between aspirin use and risk of prostate cancer death.[18]
  • Warfarin – 17-31% lower risk in users versus non-users.[19-21]

References

  1. Zhang F, Yang Y, Skrip L, et al. Diabetes mellitus and risk of prostate cancer: an updated meta-analysis based on 12 case-control and 25 cohort studies. Acta Diabetol 2012;49 Suppl 1:235-46.
  2. Xu H, Jiang HW, Ding GX, et al. Diabetes mellitus and prostate cancer risk of different grade or stage: a systematic review and meta-analysis. Diabetes Res Clin Pract. 2013;99(3):241-9.
  3. Xu H1, Mao SH, Ding GX, et al. Diabetes mellitus reduces prostate cancer risk - no function of age at diagnosis or duration of disease. Asian Pac J Cancer Prev. 2013;14(1):441-7.
  4. Chen YB, Chen Q, Wang Z, et al. Insulin therapy and risk of prostate cancer: a systematic review and meta-analysis of observational studies. PLoS One. 2013;8(11):e81594.
  5. Tang X, Yang L, He Z, et al. Insulin glargine and cancer risk in patients with diabetes: a meta-analysis. PLoS One. 2012;7(12):e51814.
  6. Bosetti C, Rosato V, Buniato D, et al. Cancer risk for patients using thiazolidinediones for type 2 diabetes: a meta-analysis. Oncologist. 2013;18(2):148-56.
  7. Soranna D, Scotti L, Zambon A, et al. Cancer risk associated with use of metformin and sulfonylurea in type 2 diabetes: a meta-analysis. Oncologist. 2012;17(6):813-22.
  8. Gandini S, Puntoni M, Heckman-Stoddard BM, et al. Metformin and cancer risk and mortality: a systematic review and meta-analysis taking into account biases and confounders. Cancer Prev Res (Phila) 2014;7(9):867-85.
  9. Ni J, Qiu LJ, Hu LF, et al. Lung, liver, prostate, bladder malignancies risk in systemic lupus erythematosus: evidence from a meta-analysis. Lupus. 2014;23(3):284-92.
  10. Huang HB, Jiang SC, Han J, et al. A systematic review of the epidemiological literature on the risk of urological cancers in systemic lupus erythematosus. J Cancer Res Clin Oncol. 2014.
  11. Shiels MS, Cole SR, Kirk GD, et al. A meta-analysis of the incidence of non-AIDS cancers in HIV-infected individuals. J Acquir Immune Defic Syndr 2009;52:611-22.
  12. Grulich AE, van Leeuwen MT, Falster MO, et al. Incidence of cancers in people with HIV/AIDS compared with immunosuppressed transplant recipients: a meta-analysis. Lancet 2007;370:59-67.
  13. Marcus JL, Chao CR, Leyden WA, et al. Prostate cancer incidence and prostate-specific antigen testing among HIV-positive and HIV-negative men. J Acquir Immune Defic Syndr 2014;66(5):495-502.
  14. Bajaj A, DriverJAa, Schernhammer ES, et al. Parkinson's disease and cancer risk: a systematic review and meta-analysis. Cancer Causes Control. 2010 May:21(5):697-707
  15. Jacobs EJ, Newton CC, Stevens VL, et al. A large cohort study of long-term acetaminophen use and prostate cancer incidence. Cancer Epidemiol Biomarkers Prev 2011;20:1322-8.
  16. Huang TB, Yan Y, Guo ZF, et al. Aspirin use and the risk of prostate cancer: a meta-analysis of 24 epidemiologic studies. Int Urol Nephrol. 2014 Apr 1.
  17. Liu Y, Chen JQ, Xie L, et al. Effect of aspirin and other non-steroidal anti-inflammatory drugs on prostate cancer incidence and mortality: a systematic review and meta-analysis. BMC Med. 2014 Mar 28;12(1):55.
  18. Rothwell PM, Fowkes FG, Belch JF, et al. Effect of daily aspirin on long-term risk of death due to cancer: analysis of individual patient data from randomised trials. Lancet 2011;377:31-41.
  19. Pottegard A, Friis S, Hallas J. Cancer risk in long-term users of vitamin K antagonists: A population-based case-control study. Int J Cancer 2012.
  20. Pengo V, Noventa F, Denas G, et al. Long-term use of vitamin K antagonists and incidence of cancer: a population-based study. Blood 2011;117:1707-9.
  21. Tagalakis V, Tamim H, Blostein M, et al. Use of warfarin and risk of urogenital cancer: a population-based, nested case-control study. Lancet Oncol 2007;8:395-402.
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Dairy products, diets high in calcium, and low blood levels of alpha-tocopherol or selenium, are classified by the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) as possible causes of prostate cancer, based on limited-suggestive evidence.[1]

WCRF/AICR make no judgment on the association between prostate cancer risk and intake of cereals (grains) and their products, dietary fibre, potatoes, non-starchy vegetables, fruits, pulses (legumes), processed meat, red meat, poultry, fish, eggs, total fat, saturated fatty acids, monounsaturated fatty acids, polyunsaturated fatty acids, plant oils, sugar (sucrose), sugary foods and drinks, coffee, tea, alcoholic drinks, carbohydrate, protein, vitamin A, retinol, alpha carotene, lycopene, folate, thiamin, riboflavin, niacin, vitamin C, vitamin D, vitamin E supplements, gamma-tocopherol, multivitamins, selenium supplements, iron, phosphorus, calcium supplements, zinc, physical activity, energy expenditure, vegetarian diets, Seventh-day Adventist diets, individual dietary patterns, body fatness (non-advanced prostate cancer), birth weight, or energy intake, due to limited evidence.[1]

Prostate cancer risk is probably not associated with intake of the following foods and supplements, meta- and pooled analyses or systematic reviews have shown:

  • Selenium supplements[2] or blood/toenail levels,[2] (though some evidence of decreased risk[3]).
  • Lycopene (dietary from tomatoes, or blood levels).[4-6]
  • Calcium[7] (though some evidence of higher risk[8]).
  • Red and processed meat.[9-11]
  • Vitamin E and retinol (Vitamin A from animal sources) (blood levels and supplement use).[12,13]
  • Vitamin D supplements[14] (though some evidence of higher risk with highest versus lowest blood 25(OH)D levels[15]).
  • Vitamin C supplements.[13]
  • Dairy products[7] (though some evidence of higher risk).[8,16]
  • Fish (though some evidence of lower prostate cancer death risk).[17]
  • Blood cholesterol levels[18] (though conflicting findings[19-24]).
  • Coffee (though some evidence of lower risk).[25-28]
  • Green tea (though some evidence of lower risk).[29-31]
  • Black tea.[29-31]
  • Alpha-linolenic acid (an omega-3 fatty acid found in plants).[31-34]

References

  1. World Cancer Research Fund. Diet, Nutrition, Physical Activity and Prostate Cancer .WCRF:London;2014.
  2. Dennert G, Zwahlen M, Brinkman M, et al. Selenium for preventing cancer. Cochrane Database Syst Rev 2011:CD005195.
  3. Hurst R, Hooper L, Norat T, et al. Selenium and prostate cancer: systematic review and meta-analysis. Am J Clin Nutr 2012;96:111-22.
  4. Etminan M, Takkouche B, Caamano-Isorna F. The role of tomato products and lycopene in the prevention of prostate cancer: a meta-analysis of observational studies. Cancer Epidemiol Biomarkers Prev 2004;13:340-5.
  5. Ilic D, Misso M. Lycopene for the prevention and treatment of benign prostatic hyperplasia and prostate cancer: a systematic review. Maturitas 2012;72:269-76
  6. Ilic D, Forbes KM, Hassed C. Lycopene for the prevention of prostate cancer. Cochrane Database Syst Rev 2011:CD008007.
  7. Huncharek M, Muscat J, Kupelnick B. Dairy products, dietary calcium and vitamin D intake as risk factors for prostate cancer: a meta-analysis of 26,769 cases from 45 observational studies. Nutr Cancer 2008;60:421-41.
  8. Gao X, LaValley MP, Tucker KL. Prospective studies of dairy product and calcium intakes and prostate cancer risk: a meta-analysis. J Natl Cancer Inst 2005;97:1768-77.
  9. Bagnardi V, Rota M, Botteri E, et al. Alcohol consumption and site-specific cancer risk: a comprehensive dose-response meta-analysis. Br J Cancer. 2015 Feb 3;112(3):580-93
  10. Bagnardi V, Blangiardo M, La Vecchia C, et al. A meta-analysis of alcohol drinking and cancer risk. Br J Cancer 2001;85:1700-5.
  11. Dennis LK. Meta-analysis for combining relative risks of alcohol consumption and prostate cancer. Prostate 2000;42:56-66.
  12. Key TJ, Appleby PN, Allen NE, et al. Plasma carotenoids, retinol, and tocopherols and the risk of prostate cancer in the European Prospective Investigation into Cancer and Nutrition study. Am J Clin Nutr 2007;86:672-81.
  13. Wang L, Sesso HD, Glynn RJ, et al. Vitamin E and C supplementation and risk of cancer in men: posttrial follow-up in the Physicians' Health Study II randomized trial. Am J Clin Nutr. 2014 Sep;100(3):915-23
  14. Bjelakovic G, Gluud LL, Nikolova D, et al. Vitamin D supplementation for prevention of cancer in adults. Cochrane Database Syst Rev. 2014 Jun 23;6
  15. Xu Y, Shao X, Yao Y, et al. Positive association between circulating 25-hydroxyvitamin D levels and prostate cancer risk: new findings from an updated meta-analysis. J Cancer Res Clin Oncol. 2014;140(9):1465-77.
  16. Wright ME, Bowen P, Virtamo J, et al. Estimated phytanic acid intake and prostate cancer risk: a prospective cohort study. Int J Cancer 2012;131:1396-406.
  17. Szymanski KM, Wheeler DC, Mucci LA. Fish consumption and prostate cancer risk: a review and meta-analysis. Am J Clin Nutr 2010;92:1223-33.
  18. Esposito K, Chiodini P, Capuano A, et al. Effect of metabolic syndrome and its components on prostate cancer risk: meta-analysis. J Endocrinol Invest. 2013;36(2):132-9.
  19. Platz EA, Till C, Goodman PJ, et al. Men with low serum cholesterol have a lower risk of high-grade prostate cancer in the placebo arm of the prostate cancer prevention trial. Cancer Epidemiol Biomarkers Prev 2009;18:2807-13.
  20. Mondul AM, Weinstein SJ, Virtamo J, et al. Serum total and HDL cholesterol and risk of prostate cancer. Cancer Causes Control 2011;22:1545-52.
  21. Shafique K, McLoone P, Qureshi K, et al. Cholesterol and the risk of grade-specific prostate cancer incidence: evidence from two large prospective cohort studies with up to 37 years' follow up. BMC Cancer 2012;12:25.
  22. Jacobs EJ, Stevens VL, Newton CC, et al. Plasma total, LDL, and HDL cholesterol and risk of aggressive prostate cancer in the Cancer Prevention Study II Nutrition Cohort. Cancer Causes Control 2012;23:1289-96.
  23. Mondul AM, Clipp SL, Helzlsouer KJ, et al. Association between plasma total cholesterol concentration and incident prostate cancer in the CLUE II cohort. Cancer Causes Control 2010;21:61-8.
  24. Platz EA, Clinton SK, Giovannucci E. Association between plasma cholesterol and prostate cancer in the PSA era. Int J Cancer 2008;123:1693-8.
  25. Cao S, Liu L, Yin X, et al. Coffee consumption and risk of prostate cancer: a meta-analysis of prospective cohort studies. Carcinogenesis. 2014;35(2):256-61.
  26. Discacciati A, Orsini N, Wolk A. Coffee consumption and risk of nonaggressive, aggressive and fatal prostate cancer--a dose-response meta-analysis. Ann Oncol. 2013.
  27. Zhong S, Chen W, Yu X, et al. Coffee consumption and risk of prostate cancer: an up-to-date meta-analysis. Eur J Clin Nutr. 2013.
  28. Lu Y, Zhai L, Zeng J, et al. Coffee consumption and prostate cancer risk: an updated meta-analysis. Cancer Causes Control. 2014;25(5):591-604.
  29. Zheng J, Yang B, Huang T, et al. Green tea and black tea consumption and prostate cancer risk: an exploratory meta-analysis of observational studies. Nutr Cancer 2011;63:663-72.
  30. Lin YW, Hu ZH, Wang X, et al. Tea consumption and prostate cancer: an updated meta-analysis. World J Surg Oncol. 2014;12:38.
  31. Yu F, Jin Z, Jiang H, et al. Tea consumption and the risk of five major cancers: a dose-response meta-analysis of prospective studies. BMC Cancer. 2014;14:197.
  32. Chua ME, Sio MC, Sorongon MC, et al. Relationship of dietary intake of omega-3 and omega-6 Fatty acids with risk of prostate cancer development: a meta-analysis of prospective studies and review of literature. Prostate Cancer 2012;2012:826254.
  33. Brouwer IA, Katan MB, Zock PL. Dietary alpha-linolenic acid is associated with reduced risk of fatal coronary heart disease, but increased prostate cancer risk: a meta-analysis. J Nutr 2004;134:919-22.
  34. Simon JA, Chen YH, Bent S. The relation of alpha-linolenic acid to the risk of prostate cancer: a systematic review and meta-analysis. Am J Clin Nutr 2009;89:1558S-64S.
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Prostate cancer risk is probably not associated with the following behaviours, meta- and pooled analyses or systematic reviews have shown:

  • Alcohol drinking (though some evidence of higher risk).[1]
  • Tobacco smoking (though some evidence of higher risk).[2]
  • Smokeless tobacco (though some evidence of higher risk).[3]

References

  1. Rota M, Scotti L, Turati F, et al. Alcohol consumption and prostate cancer risk: a meta-analysis of the dose-risk relation. Eur J Cancer Prev 2012;21:350-9.
  2. Huncharek M, Haddock KS, Reid R, et al. Smoking as a risk factor for prostate cancer: a meta-analysis of 24 prospective cohort studies. Am J Public Health 2010;100:693-701.
  3. Lee PN, Hamling J. Systematic review of the relation between smokeless tobacco and cancer in Europe and North America. BMC Med 2009;7:36.
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Prostate cancer risk is probably not associated with the following medical conditions and treatments, meta- and pooled analyses or systematic reviews have shown:

  • Statins (though some evidence of risk decrease).[1-6]
  • Digoxin.[7,8]
  • Non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs).[9]
  • Knee or hip replacement (some evidence of risk decrease but probably due to detection bias).[10,11]
  • Sexually transmitted infections (though higher risk for gonorrhea and herpes).[12,13]

References

  1. Dale KM, Coleman CI, Henyan NN, et al. Statins and cancer risk: a meta-analysis. JAMA 2006;295:74-80.
  2. Kuoppala J, Lamminpaa A, Pukkala E. Statins and cancer: A systematic review and meta-analysis. Eur J Cancer 2008;44:2122-32.
  3. Bonovas S, Filioussi K, Sitaras NM. Statin use and the risk of prostate cancer: A meta-analysis of 6 randomized clinical trials and 13 observational studies. Int J Cancer 2008;123:899-904.
  4. Browning DR, Martin RM. Statins and risk of cancer: a systematic review and meta-analysis. Int J Cancer 2007;120:833-43.
  5. Bansal D, Undela K, D'Cruz S, et al. Statin use and risk of prostate cancer: a meta-analysis of observational studies. PLoS One 2012;7:e46691.
  6. Jespersen CG, Nørgaard M, Friis S, et al. Statin use and risk of prostate cancer: A Danish population-based case-control study, 1997-2010. Cancer Epidemiol. 2014;38(1):42-7.
  7. Wright JL, Hansten PD, Stanford JL. Is digoxin use for cardiovascular disease associated with risk of prostate cancer? . Prostate. 2014;74(1):97-102.
  8. Flahavan EM, Sharp L, Bennett K, et al. A cohort study of digoxin exposure and mortality in men with prostate cancer. BJU Int. 2013.
  9. Liu Y, Chen JQ, Xie L, et al. Effect of aspirin and other non-steroidal anti-inflammatory drugs on prostate cancer incidence and mortality: a systematic review and meta-analysis. BMC Med. 2014 Mar 28;12(1):55.
  10. Visuri T, Pukkala E, Pulkkinen P, et al. Decreased cancer risk in patients who have been operated on with total hip and knee arthroplasty for primary osteoarthrosis: a meta-analysis of 6 Nordic cohorts with 73,000 patients. Acta Orthop Scand 2003;74:351-60.
  11. Onega T, Baron J, MacKenzie T. Cancer after total joint arthroplasty: a meta-analysis. Cancer Epidemiol Biomarkers Prev 2006;15:1532-7.
  12. Caini S, Gandini S, Dudas M, Bremer V, Severi E, Gherasim A. Sexually transmitted infections and prostate cancer risk: A systematic review and meta-analysis. Cancer Epidemiol 2014;38(4):329-338.
  13. Ge X, Wang X, Shen P. Herpes simplex virus type 2 or human herpesvirus 8 infection and prostate cancer risk: A meta-analysis. Biomed Rep. 2013;1(3):433-439.
Last reviewed:

Prostate cancer risk is probably not associated with the following other factors, meta- and pooled analyses or systematic reviews have shown:

  • Blood testosterone, other androgen and oestrogen levels.[1]
  • Androgenetic alopecia (male pattern baldness) (some evidence of risk increase with vertex pattern baldness).[2,3]
  • Circadian rhythm disruption e.g. through night shift work (some evidence of risk increase).[4]

References

  1. Roddam AW, Allen NE, Appleby P, et al. Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies. J Natl Cancer Inst 2008;100:170-83.
  2. Muller DC, Giles GG, Sinclair R, et al. Age-Dependent Associations between Androgenetic Alopecia and Prostate Cancer Risk. Cancer Epidemiol Biomarkers Prev 2013.
  3. Amoretti A, Laydner H, Bergfeld W. Androgenetic alopecia and risk of prostate cancer: a systematic review and meta-analysis. J Am Acad Dermatol. 2013;68(6):937-43.
  4. Sigurdardottir LG, Valdimarsdottir UA, Fall K, et al. Circadian disruption, sleep loss, and prostate cancer risk: a systematic review of epidemiologic studies. Cancer Epidemiol Biomarkers Prev. 2012;21(7):1002-11.
Last reviewed:

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