Most common non skin cancer in males.
Up to 1 in 8 men (12.5 %) will be diagnosed in their lifetime.
Up to 1 in 40 men (2.5 %) will die from prostate cancer.
Second leading cause of cancer death in men in Aust (5th worldwide)
In Aust:
- Incidence / number of diagnoses peaked 2009
- Incidence rates increase with age to a peak at 70 – 74, then decrease
- There may be slightly worse mortality rates in rural and remote Australians
- Lower incidence/diagnosis in Indigenous Australians, but perhaps poorer survival
Incidental prostate cancer:
- 20 – 25 % or more at radical cystoprostatectomy
- 5 – 10 % at TURP
- Autopsy systematic review – 20 – 40 % aged 50 – 70, to a prevalence of 59 % by 80 year
Geographic distribution:
- Wide variation between areas
- Highest incidence in Aust/NZ and North America, followed by Western and Northern Europe – age-standardised rates around 100 / 100 000
- Largely due to PSA testing and ageing populations
- Incidence much lower in Eastern and South-Central Asia – age-standardised rates 5 – 10 / 100 000
- Mortality rates vary less, but are higher in populations of African descent and lower in Asia
Risk factors:
Both genetics and environment play a role in the development of prostate cancer.
The main definitive proven risk factors for prostate cancer are:
- Age
- Family history & genetic predisposition
- Ethnicity
There are many proposed associations with developing prostate cancer but none have been definitively proven and currently there are no definitive modifiable risk factors.
Ethnicity
African-Americans and Jamaicans of African descent have the higher rates of prostate cancer incidence in the world, and at least twice as high mortality.
Thought to be multi-factorial – partly biologically more aggressive, partly social (different screening and treatment patterns)
Men with Asian backgrounds who are born in the US have a lower incidence of prostate cancer than white Americans, but a higher incidence compared to men of their background born in Asia
Family History
Whilst only 5 – 10 % of prostate cancers are thought to be truly hereditary in nature or caused by high risk inherited factors, there is a definite increase in risk in men with relatives with prostate cancer.
Relative risk increases with number of affected family members, degree of relation, and younger age at diagnosis.
- First degree relative – 2 x risk
- 2 x first degree relatives – at least 4 x risk
