While all males risk developing prostate cancer, a certain percentage are genetically predisposed to develop the condition.

Prostate cancer is the second most common cancer in males in the United States, with around 1 in 8 developing it during their lifetime. It is the second leading cause of cancer-related deaths in males, behind lung cancer. However, most people who develop it survive.

Anyone with a prostate can develop cancer. However, certain factors, including genetics, can increase the risk of developing the condition.

This article explores how genetics affect prostate cancer, other risk factors, prevention, and more.

A note about sex and gender

Sex and gender exist on spectrums. This article will use the terms “male,” “female,” or both to refer to sex assigned at birth. Click here to learn more.

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An estimated 5–15% of all prostate cancer cases occur due to abnormalities in certain hereditary genes.

“Hereditary” means that the changes to the gene came from a set a person inherited from their parents.

A person may not realize they have gene mutations or irregularities. Some signs a person may have genes linked to prostate cancer include:

  • having multiple family members with prostate cancer, often before the age of 55
  • the presence of metastasized prostate cancer — once diagnosed, if the cancer develops outside the prostate, it may indicate a genetic connection
  • a family history of prostate cancer, breast cancer, ovarian cancer, pancreatic cancer, or colon cancer

Several different genes may affect the development of prostate cancer. Currently, researchers focus on the following genes:

  • mismatch repair (MMR) genes, including MLH1, MSH2, MSH6, and PMS2
  • homologous recombination genes, including breast cancer 1 (BRCA1), breast cancer 2 (BRCA2), ATM, PALB2, and CHEK2
  • other possible genes requiring more research, which include HOXB13, BRP1, and NSB1

Other cancers connected to BRCA1 and BRCA2 mutations

Mutations to the BRCA1 and BRCA2 genes can increase the risk of someone developing breast and ovarian cancer. About 3% of breast cancer cases and 10% of ovarian cancer cases occur due to mutations in either gene.

A person inherits one copy of the genes from each parent. A mutation on one can increase a person’s risk of developing breast, ovarian, prostate, or other cancers, but it does not necessarily mean a person will develop cancer.

Cancer often occurs when the second, non-mutated copy of the gene occurs during a person’s lifetime.

Several factors beyond genetic mutations can increase a person’s risk of developing prostate cancer. Common risk factors include:

  • Age: The majority of cases occur in males over the age of 65.
  • Race or ethnicity: Prostate cancer occurs more frequently in people with African ancestry and less frequently in people with Asian, Hispanic, or Latino ancestry.
  • Geography: Most cases occur in North America, Australia, northwestern Europe, and the Caribbean islands.

Additional factors may also influence the development of prostate cancer. However, their exact role is still not clear. Some possible risk factors include:

  • obesity
  • diet, such as consuming more dairy
  • smoking
  • sexually transmitted infections (STIs)
  • inflammation of the prostate

A person may not be able to prevent prostate cancer from occurring.

Living with one or more risk factors does not mean a person will develop prostate cancer. It only means they have a higher risk than other people who do not have the same risk factors.

Similarly, a person with no risk factors can develop prostate cancer, even if they take steps to lower their risk.

Experts generally recommend making diet and lifestyle changes to reduce the number of modifiable risk factors. Making some changes may help to reduce the chance of developing prostate cancer and help reduce its severity if it occurs.

Suggestions to help prevent prostate cancer include:

  • exercising regularly
  • making dietary changes, including:
    • eating fewer calories
    • limiting calcium intake
    • following an anti-inflammatory diet with more vegetables and fruits and limiting red meats, processed foods, and added sugars
  • limiting alcohol intake, if applicable
  • avoiding or stopping smoking, if applicable
  • managing underlying conditions, including high blood pressure and cholesterol
  • reducing stress where possible
  • attending regular screenings for prostate cancer as directed by a healthcare professional

Screening for prostate cancer

Prostate screening can help find prostate cancer. However, it is still unknown whether screening for prostate cancer outweighs the risk.

Screenings check for signs of the condition. However, a doctor cannot use them to diagnose prostate cancer. If a test result is abnormal, a doctor may recommend:

  • waiting and retesting
  • trying another test, such as a digital rectal exam (DRE), specific types of prostate-specific antigen (PSA) blood tests, or imaging scans of the prostate
  • ordering a biopsy to confirm

PSA blood tests can indicate a problem with the prostate. However, several different benign conditions can also affect PSA levels.

Another standard screening method is a DRE, which involves a doctor inserting a gloved finger into the rectum to feel for abnormalities. They may be able to feel a tumor located toward the back of the prostate.

A person should discuss their risk of cancer with a healthcare professional. They can review the pros and cons of getting screened and help determine the next steps following the results.

The following are some typical questions people ask about prostate cancer.

Who is at high risk for prostate cancer?

Anyone with a prostate can develop this type of cancer, but certain groups have a higher chance. They include:

  • men over the age of 65
  • people with African ancestry
  • people living in North America, northwestern Europe, Australia, and the Caribbean

Other factors may also influence the development of prostate cancer, although it is unclear exactly how. These include:

  • smoking
  • obesity
  • a history of STIs
  • an unhealthy diet

What are the main warning signs of prostate cancer?

People should speak with a doctor about signs that could indicate prostate cancer or other conditions, including:

  • a weak or interrupted urine flow
  • difficulty beginning urination
  • pain during urination
  • frequent urination, particularly at night
  • painful ejaculation
  • difficulty emptying the bladder
  • blood in semen or urine
  • continuous back, pelvis, or hip pain

At what age is a person most likely to develop prostate cancer?

Prostate cancer is rare in people under the age of 40. It becomes more common after 50, and most cases occur in males over the age of 65.

Several genes may increase a person’s chance of developing prostate cancer. A family history or history of metastasized cancer may indicate that genes played a role in its development or that a person has a higher risk.

A person may not be able to prevent prostate cancer. However, they can take steps to reduce their risk. Steps can include making changes to their diet, exercising regularly, and avoiding smoking.

Screenings may help some people, but a person should discuss the advantages and disadvantages with a doctor to determine whether screenings are necessary or recommended.