The Risk Factors of Prostate Cancer
Prostate cancer is a disease which solely affects the male population, accounting for the second most common cause of death in men worldwide. It is a form of cancer which develops within the prostate gland of one out of every ten men across their lifetime, with 50% of men aged over 50 years old displaying areas of prostate cancer cell growth and 80% of men aged over 80 years old presenting small areas of prostate cancer development. Therefore, its most associated risk factor is thought to be age. Accordingly, there is relatively no risk involved in patients less than 50 years old, with two out of three cases affecting patients aged over 65 years old. However, prostate cancer cell growth can ensue via two forms: either with a very slow-onset, starting growth from the age of puberty and growing throughout the adult man’s life, without posing much threat, or a much faster and aggressive onset, which is also commonly symptomatic and found more frequently in younger males.
In addition to this, ethnicity has also been found to be a risk factor commonly attributed to prostate cancer. For instance, a number of different studies have stated that black African and black Caribbean men have a much higher risk for prostate cancer development, especially at younger ages, than that of the white male population, with South Asian men believed to have a much lower associated risk. A 2011 review article assessed the reasons behind this, concluding that combinations of inherited genes, as well as a number of different dietary and environmental factors were primarily responsible for the differences in development risk across ethnicities.
Consequently, diet has also been listed as a potential risk factor for prostate cancer development, commonly affiliated with over-ingestion of high-fat dairy products particularly within Western diets. A study by Shirai et al investigated into this, determining that the use of a particular heterocycline amine found within red meat, elicited a carcinogenic effect on the prostate. However, studies have since proved contradictory to this and the overall effect of nutrition on prostate cancer risk is still relatively unclear. Nonetheless, certain nutritional compounds such as anti-oxidants or flavonoids are believed to evoke a protective effect against prostate cancer, with the high ingestion of isoflavones within the South Asian diet thought to be one of the reasons explaining the difference in mortality rates between Japan and the USA.
An increased risk of prostate cancer development can also be induced via a family history of prostate cancer itself, as well as a number of other cancer forms such as breast or ovarian. This is thought to be due to the association with hereditary breast and ovarian cancer syndrome (HBOC) and the potential inheritance of germ line mutations within the BRCA1 or BRCA2 genes, resulting in a 39% increased risk of prostate cancer development. This is supported by the results of a recent study which determined that the inheritance of a faulty BRCA2 gene initiated a more rapid spread of the cancer around the prostate into a more aggressive form, resulting in conclusions to be drawn for an increased availability of faster, and more efficient treatments. Correspondingly, it has since been determined that mutations within the BRCA2 gene have a 8.6-fold increased risk for prostate cancer development, whereas mutations in the BRCA1 gene elicit a 3.4-fold increased risk; therefore depicting the underlying importance of family background. However despite this, inherited prostate cancers only account for 1 in 10 of all cases.
Another causative risk factor thought to be associated with a carcinogenic onset on the prostate corresponds to insulin-like growth factor-1 (IGF-1) levels. Over-expression has been found to cause the growth of a prostate adenocarcinoma, and under-expression found to make prostate cancer cells resistant to metastatic sites and, as such, confer endurance benefit in the body. Furthermore, a meta-analysis also found a 12% elevated risk in relation to each 10cm increase in adult height and likewise, recent studies have also discovered an association between prostate cancer developments with patients having previously suffered from kidney cancer, stating a 69% increased risk.
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