Edward Giovannucci

Epidemiology of and Risk Factors for Prostate Cancer

Prostate cancer (CaP) is the second leading cause of cancer death in US males, and it accounts for almost 30% of all cancers diagnosed in men. During the 1990s, the CaP incidence rate rapidly increased, which has been mainly attributed to heightened screening using prostate-specific antigen (PSA). Established risk factors for CaP are primarily nonmodifiable; these include older age; race, with greatest risk being among African Americans followed by Caucasians; and a family history of CaP. Possible modifiable risk factors are now beginning to emerge, including those that increase risk, such as intake of saturated fat and calcium, and those that decrease risk, such as selenium, vitamin E, and tomato products, which contain the carotenoid lycopene. Androgens, vitamin D, and insulin-like growth factor-1 (IGF-1) have been explored recently for their relationship with CaP risk; these hormonal systems may be influenced by external factors, such as diet, as well as genetics.