Prostate cancer is the most common cancer in Australian men after skin cancer. An estimated 20,000 Australian men were diagnosed with it in 2010.
Among 1000 Australian men, on average about 193 would be expected to be diagnosed with it before 80 years, but far fewer – about 23 – would die of it. We know that many older men have small amounts of prostate cancer in their gland, but lead a normal life without it causing them any problem. Studies suggest that over 40% of men aged 70 and older have ‘latent’ or hidden prostate cancer.
Men who are at high risk of developing prostate cancer are those with a father or brother (first degree relative) who had prostate cancer at an early age. A man whose father was diagnosed at 50 years is at least twice as likely to develop the disease as a man without such a history. The risk is higher if more than one relative has been diagnosed with prostate cancer. For example, one study suggests that a man with two first degree relatives affected is at least five times more likely to get it.
Certain inherited genes can raise the risk of prostate cancer. For example, inherited mutations in BRCA1 or BRCA2 genes (which are also associated with breast and ovarian cancer) may raise the risk of prostate cancer. But mutated genes account for a very small percentage of all prostate cancers.
Some experts recommend men at high risk are tested regularly, beginning in their 40s.
Younger men have a smaller chance of a prostate cancer diagnosis in any one year than older men. If they do get prostate cancer, however, younger men are more likely to die prematurely from it than older men.This is because there is more time for the cancer to progress and older men are more likely to die of other causes.
The best chance of detecting prostate cancer is by having both a blood test and a digital rectal (DRE) examination.
Low or moderate risk
As stated above, a man’s age affects both his risk of developing prostate cancer and whether it is likely to threaten his life. Prostate cancer is rarely found in men under the age of 40, if there is no family history, and so this group is at low risk. Men 40–75 years are at low to moderate risk of developing prostate cancer (see Table 1). However if they do get it, there is quite a high chance (2 in 3) that it will ultimately threaten life. This is because although most cancers grow slowly, over a long period (8 or more years), the cancer has enough time to progress.
Men older than 75 years face many other health risks. While they are most likely to be diagnosed with prostate cancer, they are least likely to be affected by it over the remaining course of their life.