What are the causes and risk factors for prostate cancer ?

The causes and risk factors for prostate cancer are multiple. Some of these factors are directly related to an individual's constitution (constitutional factors), while others are related to the environment (environmental factors).

Constitutional factors

Heredity

Among constitutional factors, heredity can play a role: 5% of prostate cancers are hereditary forms. This percentage increases to 15% when the cancer is detected before the age of 55.

A hereditary form may be suspected when at least three first-degree (father, brother) or second-degree relatives (grandfather, uncle, nephew, half-brother) have had prostate cancer, when two first-degree or second-degree relatives were diagnosed with prostate cancer before the age of 55, or when there are cases of ovarian or breast cancer in the female relatives.

These hereditary forms are due to inherited genetic mutations.

TO REMIND YOU

Genetic mutations are changes that occur in one or more genes, the small fragments of DNA that guide the functioning of cells.

Hereditary genetic mutations are passed from a parent to a child.

Some of these mutations can increase the risk of developing prostate cancer . These mutations are identified in blood cells after a simple blood test or in cancer cells from a biopsy or surgical specimen.

The discovery of certain mutations can alter the treatment of cancer.

Genetic risk factors

Among the mutations that predispose to prostate cancer, those affecting the breast cancer gene 1 (BRCA1) or the breast cancer gene 2 (BRCA2) are strongly suspected. Men who are suspected of having a hereditary form of prostate cancer should be offered a study of these two genes.

Additionally, they should have an annual consultation with a urologist, including a digital rectal exam and PSA testing, to detect potential prostate cancer early (see further details).

However, it is clear that hereditary forms of prostate cancer are most often due to multiple mutations in various genes.

Other risk factors

  • Age : Among the mutations predisposing to prostate cancer, those affecting the Breast Cancer Gene 1 (BRCA1) or Breast Cancer Gene 2 (BRCA2) are strongly suspected. Men suspected of having a hereditary form of prostate cancer should be offered genetic testing for these two genes.
  • Ethnicity : Additionally, they should receive an annual consultation with a urologist, including digital rectal examination and PSA testing, to detect potential prostate cancer early (see further). However, it is clear that hereditary forms of prostate cancer are most often due to multiple mutations across different genes.

Environmental factors

In addition to these constitutional factors, several environmental factors may increase the risk of prostate cancer. Among these are dietary factors such as low vitamin D levels.

Chlordecone, an insecticide used from 1972 to 1993 in the French West Indies to combat banana weevils, is also implicated.

Since 2021, prostate cancer linked to overexposure to chlordecone has been officially recognized as an occupational disease.

Other environmental risk factors are more uncertain, such as the HMRV virus found in 30% of prostate cancer patients, sexually transmitted diseases, obesity, lack of exercise, or tobacco use (source arcagy.org).

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Article updated on Nov 21, 2024

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