What Causes Prostate Cancer, and How Do You Prevent It?

Prostate cancer is one of the most common cancers worldwide. In fact, about 1 in 8 men in the U.S. will get it during their lifetime. Experts aren’t sure exactly what causes prostate cancer. But it seems to be linked to many different factors — including gene changes and certain health conditions. It’s also associated with other factors like age, ethnicity, diet, and activities. 

Research also shows there are different types of prostate cancer with different risks. The causes of more aggressive prostate cancers can be different from those that grow more slowly. Some of the causes of aggressive prostate cancers are related to lifestyle, which means there are strategies you can use to potentially lower your risk.

What causes prostate cancer?

Cancer is a disease where cells in your body grow and accumulate in an abnormal way. 

This typically happens because of a combination of: 

• Your genetics

• The environment your body is exposed to

• Age (cancer becomes more likely as you get older) 

Prostate cancer probably begins with changes in your genes (DNA). Genes control how your cells function and behave — including how they grow. But sometimes, the genes in your prostate cells can change or get damaged. This can lead to abnormal prostate cells that grow too fast, turning into cancer cells. 

As the cancer cells continue to grow, they can crowd out healthy cells. Over time, the cancer cells can also spread into other parts of your body and cause problems.

Who is at risk for prostate cancer?

Anyone with a prostate can develop prostate cancer — including men, trans women, and nonbinary people. While there’s no way to know for sure who will get it, researchers have identified several factors that can raise your risk. Below, we’ll break down some common risk factors in more detail.

Age

Age is the biggest risk factor for prostate cancer. The disease is uncommon in men under 40, but the risk rises significantly after age 50. In fact, most prostate cancer diagnoses happen in people over 65. Because prostate cancer often grows slowly, older adults may live with it for years without symptoms. Still, regular screening becomes more important as you get older.

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Race and ethnicity

Race and ethnicity play a big role in prostate cancer risk. Black men are about 65% more likely to develop prostate cancer than white men. They’re also more likely to be diagnosed at a later stage and have worse outcomes. 

On the other hand, men of Asian or Pacific Islander descent tend to have a lower overall risk. Researchers are still studying why these differences exist, but they may be linked to genetics, access to healthcare, and screening practices.

Family history

Your family history is one of the strongest predictors of prostate cancer. Having a first-degree relative (like a parent, sibling, or child) with the disease raises your risk. And that risk grows even more if multiple close relatives are affected. If family members were diagnosed at a young age or died from prostate cancer, your risk is especially high. Sharing this information with a healthcare professional can help guide earlier or more frequent screening.

Inherited genes

Some inherited gene changes (mutations) can increase your likelihood of developing prostate cancer. Well-known examples include mutations in the following genes: 

• BRCA1

• BRCA2

• HOXB13

• ATM genes

• Other genes involved in DNA repair 

Scientists have also discovered that multiple smaller genetic variations, known as “polygenic risk factors,” can add up to increase your overall risk. Genetic testing can help identify these risks, and your healthcare team may recommend testing if you have a strong family history of cancer.

Environment

Your surroundings and chemical exposures can also affect your prostate cancer risk. Certain toxins, such as Agent Orange, chlordecone (an insecticide), and bisphenol A (BPA, found in some plastics), have been linked to a higher chance of developing prostate cancer. Research is ongoing to better understand these links and how they interact with each other. If you’re concerned about environmental exposures, talk to a healthcare professional about ways to reduce your risk.

Location

Where you live can influence your chances of getting prostate cancer. It’s more common in North America, northern Europe, Australia, and the Caribbean than in other parts of the world. Experts believe this could be due to differences in genetics, diet, environment, or screening practices. While you can’t change where you live, knowing your regional risk can help guide conversations about early detection.

Smoking habits

Smoking may play a role in prostate cancer risk, though studies are mixed on the exact impact. Some research suggests that smokers are more likely to develop aggressive prostate cancer or have worse outcomes after diagnosis. Quitting smoking is beneficial for your overall health and may lower your risk of many cancers, including prostate cancer. Although the link to prostate cancer isn’t entirely clear, avoiding tobacco is one of the best steps you can take for your health.

How do you diagnose prostate cancer?

If a healthcare professional suspects you have prostate cancer, they may recommend a prostate biopsy. A biopsy is a medical procedure where a small sample of cells is removed from your body. It’s the best test there is for helping diagnose prostate cancer. 

With a biopsy, it’s possible to examine the cells under a microscope to figure out if they’re cancerous — and how likely the cancer is to spread. If you do have prostate cancer, your healthcare team will assign it to a certain stage. The stage helps you and your team make decisions about your care. 

Prostate cancer staging is based on:

• Your prostate-specific antigen (PSA) level

• How far the tumor has spread in your prostate (T classification)

• How abnormal and aggressive your cancer cells are (Gleason score and grade group)

• Whether the cancer has spread to other parts of your body

Depending on what type of prostate cancer you have, your healthcare team will recommend either watchful waiting (surveillance) or appropriate treatments. 

Can diet affect your risk of prostate cancer?

The effect of diet on prostate cancer risk isn’t clear. There’s no definitive cause-and-effect connection, but there’s some evidence that prostate cancer is associated with certain foods:

• Dairy: Eating a lot of dairy may slightly increase your risk of prostate cancer.

• Foods high in fats or carbohydrates: Eating a lot of sugary or high-fat foods (especially animal products) may raise your risk for prostate cancer. These foods can also lead to a larger body size, which may change hormone levels and cause inflammation.

• Red meat: Eating red meat is associated with many different types of cancer, including prostate cancer. There’s also evidence that eating a plant-based (vegetarian or vegan) diet can lower your risk of prostate cancer.

• Processed meat: Foods like salami, bacon, and lunch meat have been shown to increase prostate cancer risk — especially when eaten often.

• Alcohol: Drinking beer, wine, and liquor may increase your risk for prostate cancer, and the evidence for this link is growing. 

Are certain health conditions associated with prostate cancer?

Yes, there’s evidence that having a body mass index (BMI) that’s greater than 30 increases your risk for aggressive prostate cancer. And this may also make you more likely to die from prostate cancer. This may be because central body fat can affect certain hormones, like insulin-like growth factor 1 (IGF-1), that are linked to prostate cancer. 

On the other hand, people who are considered obese are actually less likely to be diagnosed with nonaggressive prostate cancer. A BMI over 30 can falsely lower your prostate-specific antigen (PSA), which can delay biopsy and diagnosis. As a result, prostate cancer may be found later and appear more aggressive when it’s finally diagnosed.

There’s also some evidence that hypertension (high blood pressure) is associated with prostate cancer. A 2017 meta-analysis found that people with prostate cancer were more likely to have hypertension than the general population. More research is needed in this area. 

Is prostate cancer genetic?

Yes, cancer — including prostate cancer — is affected by genetic changes. Some of these changes are inherited from family members. Others are acquired during your life because of things like age, exposures, diet, and lifestyle.

You can have a gene change (also called a mutation) in two different ways:

1. You’re born with it: This is called an “inherited” gene mutation. In other words, your father or mother had the same mutation and passed it to you. There are over 20 different genes linked to prostate cancer. Keep in mind that both females and males can have these mutations. 

2. It happens at some point during your life: This is called an “acquired” gene mutation. This means you were not born with the gene change, but it happened at some point during your life. 

How to help prevent prostate cancer

No one knows for sure how to prevent prostate cancer. But there’s some evidence that you may be able to reduce your risk by:

• Eating a balanced diet high in whole grains, fruits, and vegetables

• Cutting back on red meat, processed meat, sugar, and alcohol

• Eating foods that are rich in vitamins and minerals

• Exercising

• Maintaining a comfortable weight 

• Quitting smoking, if you smoke

If you do have a higher risk for prostate cancer, there are some medications that can potentially reduce your risk. Talk with a healthcare professional about whether this is right for you, as there are pros and cons to this approach. 

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Written by:

Sarah Gupta, MD

Sarah Gupta, MD, is a licensed physician with a special interest in mental health, sex and gender, eating disorders, and the human microbiome. She is currently board certified by the American Board of Psychiatry and Neurology.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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