Prostate Cancer is a more commonly diagnosed disease in Western Europe and the United States than in the rest of the world. The incidence in the United States is 140/100,000 while it is only 22/100,000 in Japan and 1.4/100,000 in China. The diagnosis rate is also low in Africa and Latin America. This may be partially due to the prevalence of the Prostate Specific Antibody (PSA) testing in the US, since this form of diagnosis provides the earliest detection of the disease.
There appears to be a potential genetic component to the disease progression. Men with a close family member (father, brother, uncle, or grandfather) that had been diagnosed with Prostate Cancer have a doubled rate of diagnosis. If there were two close family members the rate of diagnosis increases by a factor of 5. Genetic testing suggests that about 10% of Prostate Cancers are genetically related; with a possible “Prostate Cancer” gene on Chromosome 1 and another on the X Chromosome.
The fact that there is a relatively low incidence of Prostate Cancer in Africa and the fact that African-Americans have the highest incidence of the disease in the United States combine to indicate that there may be an environmental component to the disease as well. There are indications that the high-fat, red-meat diet common in Northwestern Europe and the United States may play a role in the progression of the disease. Another possible factor may be the high-weight and low-exercise rates in these regions.
Prostate Canser epidemiology is indicating that there may also be a hormonal component to Prostate Cancer, not unexpectedly due to the association of the prostate with the testes. Prostate Cancer is rare among men that were castrated before puberty or in men with low levels of the enzyme that converts testosterone to dihydrotestosterone (DHT). Low levels of sex-hormone-binding-globulin, which binds excess testosterone, are also associated with higher Prostate Cancer rates. Research is on-going to determine possible chemical pathways associated with these chemicals that would specifically influence the development of Prostate Cancer.
Prostate Canser epidemiology is not able to tell if an individual actually has Prostate Cancer; it only predicts portions of the population that are most at risk. Fortunately there are two tests that are fairly effective at detecting early stages of Prostate Cancer; the Digital Rectal Exam (DRE) and the Prostate Specific Antibody (PSA) test. The American Cancer Society recommends that all men over age 50 get both tests annually. African-Americans and those men with a close relative that has been diagnosed with Prostate Cancer should start their annual tests at age 40.
Fortunately, while Prostate Cancer gets very common in old age, it is typically a slow growing, easily treatable disease, especially with early diagnosis. Prostate Canser epidemiology is able to confirm that early identification of the disease is the key to successful treatment.