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Risk Factors

Prostate cancer is the most common non-skin cancer in the United States, affecting one in six men. Age is the greatest risk factor for developing prostate cancer, with more than 65 percent of cases diagnosed in men over age 65.

Other factors play a role in your risk as well. Lifestyle factors like diet, exercise and smoking can affect your chances of developing cancer as well as how quickly it progresses. Diets high in animal fat have been linked to prostate cancer, while diets rich in lycopene, vitamin E and selenium may be linked to lower rates of prostate cancer. Eat a diet rich in fruits and vegetables and low in fat, exercise regularly (at least 30 minutes a day), limit alcohol use and quit smoking to reduce your risk of prostate and other types of cancer.

Race and genetics also affect your risk for prostate cancer. African-American men are 61 percent more likely to develop prostate cancer than Caucasian men, and more than twice as likely to die from it. If you have a first-degree relative–father, brother, son—with prostate cancer, your risk is doubled; if you have two or more relatives with the disease, your risk is quadrupled. If they were diagnosed before age 60, your risk is even higher.

PSA and DRE Screening

Whether or not to undergo prostate cancer screening is a personal decision best discussed with your doctor, who will consider your overall health and all your risk factors when weighing the benefits.

Prostate cancer that is detected at its earliest stages, before it has spread and usually before any symptoms appear, is highly curable. Finding it early also means more treatment options with possibly fewer side effects. Screenings can be performed quickly and easily in your doctor’s office.

The PSA Blood Test

During a PSA test, the level of PSA (prostate-specific antigen) in your blood is measured from a small blood sample drawn from your arm. Generally, PSA levels less than 4 ng/mL are considered normal, between 4 and 10 ng/mL are considered intermediate, and over 10 ng/mL are considered high.

While the PSA test has certain limitations, it remains an important tool in the diagnosis and treatment of prostate cancer. PSA is a protein produced by the prostate and released in very small amounts into the bloodstream. When the level of PSA in the blood grows, it generally indicates a problem. This might be cancer, but it might also be a benign condition like BPH (benign prostatic hyperplasia) or prostatitis. Occasionally men with prostate cancer have low PSA levels. For these reasons, PSA testing is most effective in conjunction with the DRE.

The Digital Rectal Exam (DRE)

During a DRE, your doctor inserts a gloved, lubricated finger into your rectum and assesses the size, shape and texture of the prostate. Your doctor can evaluate the prostate for cancer as well as noncancerous conditions like BPH.

Recommendations

You and your doctor should discuss whether or not you should undergo prostate cancer screening, taking into consideration your age, health, lifestyle and genetic factors as well as risks and benefits. You should begin these discussions at age 50, unless you are at high risk. Men at high risk should talk with their doctor beginning at age 40 or 45.