Put in the simplest way, no one knows what causes some men to get prostate cancer while other men don’t. Scientists and clinical researchers have been working hard to try to discover the answer to this very basic question. We know much more now that we did 25 years ago, but we still don’t know that much. It would be great if we could find some better answers soon!
For a while, people have suspected that there are several things that place individual men at particular risk for the development of prostate cancer. So here are the most important things we do know. The recognized risk factors for prostate cancer include age, race, genetics, and environment (potentially including one’s diet).
According to data from the National Cancer Institute, about 164,600 men in America were expected to be diagnosed with prostate cancer in 2018. This is much lower than what the American Cancer Society was projecting in 2014 (which was more like 233,000 new cases that year), and is more like the 165,000 projected for 1993 and the 184,500 in 1998. In other words, the incidence of prostate cancer rose rapidly in the 1990s (after the initial introduction of the PSA test) and has now fallen again.
Also according to the National Cancer Institute’s data, about 29,400 American men were expected to die of prostate cancer in 2018. This is down significantly from a projected number of over 37,000 in 1998, so we must be doing something right! About 2 percent of all deaths of American men are currently believed to be caused by prostate cancer. This is a large number of people, but it means that only two men in every 100 will actually die of the disease.
The fact that fewer American men are expected be found to have prostate cancer in 2018 compared to 1998 is not necessarily because fewer men are getting prostate cancer. It is, in fact, highly likely that we have become much better at differentiating between risk for clinically significant prostate cancer and risk for forms of prostate cancer that are never going to be a meaningful problem (low- and very low-risk forms of prostate cancer that are clinically insignificant).
It is also true that we are — generally — diagnosing prostate cancer earlier in men at significant risk.