Prostate cancer is the most common cancer in men. At the same time, due to the world’s growing population and increasing average life expectancy, the likelihood of developing this disease is steadily rising. Although it is most commonly seen in men over the age of 50, Prof. Dr. Volkan İzol, drawing on more than 20 years of experience in prostate cancer, has noted that “diagnoses are also being made in younger patients, and tumors in these patients may be more aggressive.”

In the diagnosis of prostate cancer, the PSA (prostate-specific antigen) test, digital rectal examination (DRE), and, in recent years, MRI imaging of the prostate are of critical importance. Prof. Dr. Volkan İzol emphasizes that “these tests must be interpreted on a case-by-case basis, and treatment plans must be tailored to patients based on their age and risk group, even when the test results are the same.”

Accurately identifying risk factors is of great importance, particularly in terms of enrolling high-risk individuals in early screening and follow-up programs.

Susceptibility to prostate cancer is shaped by the interaction of many genetic, environmental, and hormonal factors.

1. Age

Age is one of the most significant and unmodifiable risk factors for prostate cancer. While it is rarely seen in men under 50, the risk increases significantly in individuals aged 65 and older. Epidemiological studies show that more than 60% of men diagnosed with prostate cancer are over the age of 65. The incidence among men under 40 is quite low, and cases in this age group tend to be genetically inherited, more aggressive forms of the disease. For this reason, the need for screening increases with age.

2. Family History and Genetic Predisposition

If there is a family history of prostate cancer, the risk increases significantly. A family history of prostate cancer in a father, brother, or uncle increases the risk by approximately 2 to 3 times. Prof. Dr. Volkan İzol stated, “We should ask every patient presenting with prostate cancer about their family history; if the diagnosis has been made in more than one family member, or if the tumors were diagnosed at an early age and have a high Gleason score, we must be vigilant for hereditary prostate cancer, which may exhibit aggressive characteristics.”

From a genetic perspective, men who carry the BRCA2 mutation, in particular, face an increased risk of prostate cancer and are more likely to develop tumors with a more aggressive course. For this reason, genetic testing may be recommended for individuals with a family history of prostate cancer.

3. Race and Ethnicity

Ethnicity is one of the key factors influencing the incidence of prostate cancer and the behavior of the tumor. While prostate cancer is more common and more aggressive among African American men, it is less common among men of Asian descent and is generally less aggressive. This difference is thought to be due to genetic and environmental factors, as well as differences in access to health care.

4. Lifestyle and Eating Habits

Lifestyle, dietary habits, and environmental factors may have direct or indirect effects on the development of prostate cancer.

It has been observed that the risk of prostate cancer increases, particularly among individuals who follow a diet high in saturated fat and consume large amounts of red meat and dairy products.

However, there are studies indicating that the risk is reduced in people who consume foods high in antioxidants, such as lycopene (found in tomatoes), selenium, and vitamin E.

Obesity—particularly a high body mass index (BMI)—may increase the likelihood of aggressive prostate cancer. In addition, it is believed that insulin resistance, hyperglycemia, and chronic inflammation may also facilitate tumor development by affecting the tumor microenvironment.

No clear link has been established between alcohol consumption and prostate cancer, but it is known that excessive alcohol consumption increases the overall risk of cancer. Although smoking does not directly increase the risk of prostate cancer, there is evidence that it increases the risk of advanced-stage disease and death.

5. Hormones and Endocrine Factors

Although it has been suggested that testosterone and its active metabolite, dihydrotestosterone (DHT), may play a role in the development of prostate cancer, this relationship has not yet been fully clarified.

6. Infections and Chronic Inflammation

Chronic prostatitis, a much-debated topic, has not been shown to have a clear cause-and-effect relationship with either infection, benign prostatic hyperplasia, or prostate cancer. Nevertheless, chronic inflammation, particularly prostate intraepithelial neoplasia (PIN)

Conclusions and Clinical Recommendations

Risk factors for prostate cancer can be grouped into several categories, including age, genetic predisposition, ethnic background, dietary habits, hormonal factors, and obesity.

In the diagnosis of prostate cancer, the PSA (prostate-specific antigen) test, digital rectal examination (DRE), and, in recent years, MRI imaging of the prostate are of critical importance. Prof. Dr. Volkan İzol emphasizes that “these tests must be interpreted on a case-by-case basis, as the same results can lead to different outcomes in patients of different ages and risk groups.”

Following a detailed evaluation, a prostate biopsy—performed using ultrasound or, if possible, preferably MRI—is the primary diagnostic tool in suitable patients.

Being aware of risk factors and developing personalized screening programs are critical to reducing prostate cancer-related mortality.