Editing Prostate cancer (section)

== Epidemiology ==
[[File:US PC Inc by age 2016.tif|thumb|Prostate cancer incidence by age group, United States, 2016{{efn|group=note|Cancer incidence often plateaus or falls in the oldest age groups due to reduced diagnosis in people who are already in poor health.<ref>{{cite web|url=https://www.cancerresearchuk.org/health-professional/cancer-statistics/statistics-by-cancer-type/prostate-cancer/incidence#heading-One |accessdate=2 April 2024 |title=Prostate Cancer Incidence Statistics |date=15 May 2015 |publisher=Cancer Research UK}}</ref>}} |alt=Graph showing that prostate cancer incidence is very low in men under 50, and peaks in men over 65.]]

Prostate cancer is the second-most frequently diagnosed cancer in men, and the second-most frequent cause of cancer death in men (after [[lung cancer]]).{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Epidemiology"}}{{sfn|Scher|Eastham|2022|loc="Prostate cancer"}} Around 1.2 million new cases of prostate cancer are diagnosed each year, and over 350,000 people die of the disease, annually.{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Epidemiology"}} One in eight men are diagnosed with prostate cancer in their lifetime, and around one in forty die of the disease.{{sfn|Scher|Eastham|2022|loc="Prostate cancer"}} Rates of prostate cancer rise with age. Due to this, prostate cancer rates are generally higher in parts of the world with higher life expectancy, which also tend to be areas with higher [[gross domestic product]] and higher [[human development index]].{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Epidemiology"}} Australia, Europe, North America, New Zealand, and parts of South America have the highest incidence. South Asia, Central Asia, and sub-Saharan Africa have the lowest incidence of prostate cancer; though incidence is increasing quickly in these regions.{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Epidemiology"}} Prostate cancer is the most diagnosed cancer in men in over half of the world's countries, and the leading cause of cancer death in men in around a quarter of countries.{{sfn|Bergengren|Pekala|Matsoukas|Fainberg|2023|loc="3.1 Epidemiology"}}

Prostate cancer is rare in those under 40 years old,{{sfn|Pernar|Ebot|Wilson|Mucci|2018|loc="Risk factors for total prostate cancer"}} and most cases occur in those over 60 years,{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Epidemiology"}} with the average person diagnosed at 67.{{sfn|Stephenson|Abouassaly|Klein|2021|loc="Age at diagnosis"}} The average age of those who die from prostate cancer is 77.{{sfn|Stephenson|Abouassaly|Klein|2021|loc="Age at diagnosis"}} Only a minority of prostate cancer cases are diagnosed. [[Autopsies]] of men who died at various ages have shown cancer in the prostates of over 40% of men over age 50. Incidence rises with age, and nearly 70% of men autopsied at age 80–89 had cancer in their prostates.{{sfn|Dall'Era|2023|loc="General considerations"}}

=== Genetics ===
Prostate cancer is more common in families with a history of any cancer.{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Genetic predisposition"}} Men with an affected first-degree relative (father or brother) have more than twice the risk of developing prostate cancer, and those with two first-degree relatives have a five-fold greater risk compared with men with no family history.{{sfn|Scher|Eastham|2022|loc="Epidemiology"}} Increased risk also runs in some ethnic groups, with men of African and [[Afro-Caribbean people|African-Caribbean]] ancestry at particularly high risk – having prostate cancer at higher rates, and having more-aggressive prostate cancers that develop at earlier ages.{{sfn|McHugh|Saunders|Dadaev|McGrowder|2022|loc="Introduction"}} Large [[genome-wide association studies]] have identified over 100 gene variants associated with increased prostate cancer risk.{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Genetic predisposition"}} The greatest risk increase is associated with variations in [[BRCA2]] (up to an eight-fold increased risk) and [[HOXB13]] (three-fold increased risk), both of which are involved in repairing [[DNA damage]].{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Genetic predisposition"}} Variants in other genes involved in DNA damage repair have also been associated with an increased risk of developing prostate cancer – particularly early-onset prostate cancer – including [[BRCA1]], [[ATM serine/threonine kinase|ATM]], [[NBS1]], [[MSH2]], [[MSH6]], [[PMS2]], [[CHEK2]], [[RAD51D]], and [[PALB2]].{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Genetic predisposition"}} Additionally, variants in the genome near the [[oncogene]] [[MYC]] are associated with increased risk.{{sfn|Rebello|Oing|Knudsen|Loeb|2021|loc="Genetic predisposition"}} As are [[single-nucleotide polymorphism]]s in the [[vitamin D receptor]] common in African-Americans, and in the [[androgen receptor]], [[CYP3A4]], and [[CYP17]] involved in [[testosterone]] synthesis and signaling.{{sfn|Scher|Eastham|2022|loc="Epidemiology"}} Together, known gene variants are estimated to cause around 25% of prostate cancer cases, including 40% of early-onset prostate cancers.{{sfn|Scher|Eastham|2022|loc="Epidemiology"}}

=== Body and lifestyle ===
Men who are taller are at a slightly increased risk for developing prostate cancer, as are men who are [[obese]].{{sfn|Pernar|Ebot|Wilson|Mucci|2018|loc="Risk factors for advanced and fatal prostate cancer"}} High levels of blood cholesterol are also associated with increased prostate cancer risk; consequently, those who take the cholesterol-lowering drugs, [[statin]]s, have a reduced risk of advanced prostate cancer.{{sfn|Pernar|Ebot|Wilson|Mucci|2018|loc="Statins"}} Chronic inflammation can cause various cancers. Potential links between infection (or other sources of inflammation) and prostate cancer have been studied but none definitively found, and one large study found no link between prostate cancer and a history of [[gonorrhea]], [[syphilis]], [[chlamydia]], or infection with various [[human papillomavirus]]es.{{sfn|Stephenson|Abouassaly|Klein|2021|loc="Inflammation and infection"}}

Regular vigorous exercise may reduce one's chance of developing advanced prostate cancer, as can several dietary interventions.{{sfn|Pernar|Ebot|Wilson|Mucci|2018|loc="Exercise"}} Those with a diet rich in [[cruciferous vegetable]]s (certain leafy greens, broccoli, and cauliflower), [[Fish as food|fish]], [[genistein]] (found in [[soy]]), or [[lycopene]] (found in tomatoes) are at a reduced risk of symptomatic prostate cancer.{{sfn|Scher|Eastham|2022|loc="Epidemiology"}}{{sfn|Pernar|Ebot|Wilson|Mucci|2018|loc="Fish"}} Conversely, those who consume high levels of dietary fats, [[polycyclic aromatic hydrocarbons]] (from cooking red meats), or calcium may be at an increased risk of developing advanced prostate cancer.{{sfn|Scher|Eastham|2022|loc="Epidemiology"}}{{sfn|Pernar|Ebot|Wilson|Mucci|2018|loc="Calcium, dairy products, and vitamin D"}} Several dietary supplements have been studied and found not to impact prostate cancer risk, including [[selenium]], [[vitamin C]], [[vitamin D]], and [[vitamin E]].{{sfn|Scher|Eastham|2022|loc="No cancer diagnosis"}}{{sfn|Pernar|Ebot|Wilson|Mucci|2018|loc="Calcium, dairy products, and vitamin D"}}