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Prostate cancer is more common in some racial and ethnic groups.

Race and Ethnicity

• African Americans are at higher risk for prostate cancer than Caucasians and Hispanics, while the disease is less common in Asians, Pacific Islanders, American Indians and Alaskan Natives. African American men have among the highest reported incidence rates for prostate cancer, representing an estimated 12% of U.S. men diagnosed. African Americans are frequently diagnosed with more aggressive prostate cancer and at a younger age, and die more often from their diseases than men of other racial backgrounds.
• There are various reasons attributed to the higher incidence and poorer overall prognosis of prostate cancer in African American men. Family history is one possible factor. Specific genetic factors have been implicated in the higher risk for prostate cancer among African American men.

Many experts consider socio-economic factors and healthcare disparities to be the strongest causes of higher prostate cancer incidence and mortality in the African American population, and research does suggest that less access to medical care and health insurance are leading contributors. For example, because African American communities often have less knowledge about or access to PSA screening, their prostate cancer will more frequently be found at later stages than that of Euro-American men, contributing to worse outcomes. The American Cancer Society recommends PSA testing for African American men starting at age 45 due to their higher risk, while most other men without a family history are advised to speak with their physicians about PSA testing starting at age 50.

Factors that can put a man at higher risk for prostate cancer include:

• Age – Men older than age 65 are at higher risk for prostate cancer.
• Family history – A man’s risk increases if a father, brother or son developed prostate cancer. The American Cancer Society recommends that a man whose father or brother had prostate cancer at age 65 or younger should be screened with PSA testing beginning at age 45.
• Diet – There are conflicting studies about the role that diet may play in the development or prevention of prostate cancer. However, at least one large U.S. study suggests an association between the intake of processed and red meat with advanced prostate cancer. A positive association between consumption of processed meat and advanced prostate cancer was shown, but only for older men (age 65 and above), while a positive association was shown between red meat consumption and advanced prostate cancer in the younger group of men only.
• Exercise – One study found no effect of total (vigorous and nonvigorous) physical activity on prostate cancer incidence, but did find that men age 67.5 years or older engaging in at least three hours of vigorous physical activity weekly had a substantially lower risk - almost 70% - of being diagnosed with high-grade, advanced, or fatal prostate cancer.
• Pre-cancerous prostate changes – Changes such as prostatic intraepithelial neoplasia, a prostate lesion, can be a precursor to prostate cancer.
• Genetic (chromosomal) abnormalities – Abnormalities, such as an altered or missing gene, may contribute to prostate cancer risk. The National Cancer Institute categorizes “hereditary prostate cancer,” or HPC, as having at least one of the following criteria:
  
  • Three or more first-degree relatives (father, son or brother)
  • Three successive generations of maternal or paternal lineages, and/or
  • At least two relatives affected at age 55 or younger

Some families carry susceptibility genes linked to prostate cancer, or a family may carry an inherited genetic mutation in which a DNA repair mechanism is missing and prostate cancer growth is unchecked. Examples of these are BRCA2, HPC1, PCAP, HPCX, CAPB, HPC20 and 8p genes.