Prostate cancer is the most common cancer in men in the UK, but the risk is not the same for everyone. A few well-established factors make it more likely. Knowing where you stand helps you decide when to talk to your GP about testing, often years before any symptoms could appear.
Age
Age is the biggest single risk factor. Prostate cancer is rare in men under 50, and the risk rises steadily with each decade after that. Most men diagnosed are over 65.
This is one reason doctors pay closer attention to urinary symptoms and PSA results as men get older. It is also why the age thresholds used to interpret a PSA test change over time.
Black heritage
Black men have a higher risk of prostate cancer than other men. Prostate Cancer UK estimates that around 1 in 4 Black men will be diagnosed in their lifetime, about double the risk for men overall. The disease may also appear at a younger age.
The reasons are not fully understood and are likely to include genetic factors. What matters in practice is that Black men can benefit from discussing prostate health with their GP from around the age of 45.
Family history
A man whose father or brother has had prostate cancer is more likely to develop it himself. The risk is higher still if:
- more than one close relative has been affected
- a relative was diagnosed at a younger age, for example before 60
A family history of breast or ovarian cancer can also matter, because some of the same inherited gene changes raise the risk of all three cancers.
Inherited gene changes
Some men inherit changes in genes that normally help repair damaged cells. The best known are BRCA1 and BRCA2. Men who carry a BRCA2 change in particular have a higher risk of prostate cancer and may be more likely to develop a faster-growing form.
Genetic testing is not needed for most men, but it may be offered when there is a strong family history or a known gene change in the family. Our article on smart BRCA gene screening explains how this works.
Factors that may play a part
Research has looked at other possible influences, including:
- Body weight: being overweight may be linked with a higher risk of more aggressive prostate cancer.
- Diet and exercise: a balanced diet and regular activity support overall health, although no single food prevents prostate cancer.
- Height: taller men appear to have a slightly higher risk, for reasons that are unclear.
Our article answering common prostate cancer prevention questions looks at what the evidence shows.
Why higher-risk men may talk about testing earlier
There is no national screening programme for prostate cancer in the UK. Instead, men over 50 can ask their GP for a PSA test after discussing the pros and cons. The NHS prostate cancer guide explains this approach.
For men at higher risk, that conversation may be worth having sooner. Finding prostate cancer while it is still contained within the gland gives the widest choice of treatment and the best chance of cure. Our guide to smart screening describes how modern testing combines PSA with MRI to reduce unnecessary biopsies.
What to do next
If any of these risk factors apply to you, consider:
- telling your GP about your family history
- asking about a PSA test and what the result would mean for you
- keeping a record of any results so trends can be seen over time
Our prostate cancer page explains what happens if further tests are needed.
Professor Prokar Dasgupta sees men with a family history or other risk factors at The London Clinic, 145 Harley Street. Please contact the clinic to arrange a consultation.