How diet, nutrition and physical activity affect prostate cancer risk. In total, we analysed 104 studies from around the world, comprising over 9 million men and 191,000 cases of prostate cancer.
The prostate is a walnut sized gland in men that surrounds the top of the urethra just below the bladder outlet; it produces seminal fluid. Male hormones, such as testosterone, control its growth and function.
There are no other established causes of prostate cancer in addition to the findings on diet, nutrition and physical activity outlined above.
Pathogenesis: how does prostate cancer develop?
The disease usually develops slowly and dysplastic lesions may precede cancer by many years or even decades. The prevalence of latent prostate cancer at autopsy is high and increases with age. Overt and clinically relevant disease is less common. The introduction of PSA screening has contributed to the detection of cancer at an earlier stage. Although this likely contributes to a reduction in mortality, because a significant number of indolent lesions that might never progress to become clinically overt are also detected, many of which are treated, it also leads to the phenomenon of over treatment.
Adenocarcinoma of the prostate is thought to arise primarily from an in situ proliferation of neoplastic prostatic epithelial cells. Metastasis of prostatic adenocarcinoma is mainly to the lymph nodes and to bone.
Non-modifiable risk factors are age, race and familial history. Elevated blood concentrations of insulin-like growth factor (IGF)-1 have been implicated as a potentially modifiable risk factor. Other modifiable risk factors have been suggested but the evidence has been inconsistent.
Genetic susceptibility has been linked to African heritage and familial disease. In the US, African American men are 1.6 times more likely to develop prostate cancer than Caucasian men. A large number of single-nucleotide polymorphisms that modestly affect risk have also been identified.
Full references and a summary of the mechanisms underpinning all the findings can be found in the prostate cancer report.
In 2018, World Cancer Research Fund International published Diet, Nutrition, Physical Activity and Cancer: a Global Perspective on behalf of AICR, WCRF and WKOF. This was the third in our series of major reports looking at the many ways in which our diets, and how active we are, affect our cancer risk. You can find out much more about prostate cancer by downloading a pdf of the relevant chapter in the 2018 report. Please note, however, that this webpage may have been updated since the report was published.
Published findings in peer-reviewed journals
Selected findings from this report have been published in peer-reviewed journals. Details of the papers and links to the abstract in PubMed are below:
Dairy products, calcium, and prostate cancer risk: A systematic review and meta-analysis of cohort studies. Aune D, Navarro Rosenblatt DA, Chan DSM, Vieira AR, Vieira R, Greenwood DC, Vatten LJ & Norat T. Am J Clin Nutr 2014; 101(1): 87-117. Abstract