Prostate cancer causes and risk factors

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on August 19, 2022.

When it comes to prostate cancer risk, several factors can't be changed, like age, race and genes. But patients do have control over other risk factors, such as exercise level, alcohol consumption, sexual activity and other lifestyle habits.

This article will cover:

How common is prostate cancer?

Prostate cancer is the second most common cancer in men, according to the National Cancer Institute (NCI). In fact, one in eight American men is expected to be diagnosed with prostate cancer at some point in his life.

What causes prostate cancer?

Prostate cancer forms when the DNA in prostate cells develops mutations that may disable their ability to control cell growth and division. In many cases, these mutated cells die or are attacked by the immune system. However, some mutated cells may escape the immune system and grow out of control, forming a prostate tumor.

The exact causes of prostate cancer in an individual patient may not be clear. However, understanding the risk factors may help men take preventive measures to reduce the likelihood of developing prostate cancer.

What are the risk factors for prostate cancer?

Risk factors are characteristics and conditions that increase the risk for developing a disease. Prostate cancer risk factors include some that can't be changed, such as having a family history of the disease and a genetic predisposition for developing the cancer. But other risk factors may be adjusted to help lower the likelihood of developing prostate cancer. Doctors don't know why some men with risk factors don't get prostate cancer and why others with no risk factors do. Still, men may make certain lifestyle choices to try to lower their risk.

Risk factors for developing prostate cancer include those listed below.

Age: The risk for developing prostate cancer increases with age. One in 10,000 men younger than 40 are diagnosed with prostate cancer, but one in 15 men in their 60s are diagnosed with the disease.

Family history: Being born with a gene mutation is one of the unavoidable risks of prostate cancer. Two of them include the BRCA1 and BRCA2 gene mutations. BRCA and other inherited mutations, including HOXB13 and DNA mismatch repair genes, may explain why prostate cancer runs in families. Having a father or brother with prostate cancer may double a man’s risk, especially if that relative was diagnosed before age 55.

Geography: People living in North America, Australia, Northwestern Europe and the Caribbean islands are at a higher risk for developing prostate cancer than those living elsewhere. The reasons for this disparity are not clear. More intensive screening for prostate cancer in some developed countries may account for at least part of this difference, but other factors such as lifestyle differences (diet, etc.) are likely to be important as well. For example, Asian Americans have a lower risk for developing prostate cancer than White Americans, but their risk is higher than that of men of similar ethnic backgrounds living in Asia.

Prostatic intraepithelial neoplasia (PIN): This condition may be associated with increased risk of prostate cancer. PIN is a condition in which prostate gland cells look abnormal when examined with a microscope. It’s not necessarily linked with any prostate cancer symptoms. Nearly half of men will be diagnosed with PIN before age 50.

Race: Studies show that African-American men are about 70 percent more likely to develop prostate cancer in their lifetime than Caucasian or Hispanic men.

Top risk factors for prostate cancer and how they affect your risk
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Common questions about the causes of prostate cancer

Can masturbation or frequent sex reduce prostate cancer risk?

Frequent ejaculation may lower the risk of prostate cancer, according to a 2016 study of nearly 32,000 men in European Urology. The reasons for this aren’t fully known, but masturbation and sexual activity may help flush out potentially harmful chemicals in semen, or it could be that frequent ejaculation is a marker for a healthier person.

Can lack of sex cause prostate cancer?

Lack of sex is not known to cause prostate cancer. But, as noted, there is some evidence that frequent ejaculation, whether through masturbation or sex, may confer some protection against this cancer. Researchers are still trying to understand the exact biologic mechanisms that give rise to prostate cancer.

Does undergoing a vasectomy cause prostate cancer?

The link between prostate cancer and vasectomy is controversial. A 2020 study in the Journal of the National Cancer Institute suggests that undergoing a vasectomy may result in a small increased risk of prostate cancer that persists for at least three decades, regardless of the age at vasectomy. However, other studies have not found this to be true and more research is needed, according to the American Cancer Society.

Does smoking cause prostate cancer?

Smoking negatively affects all cells in the body, including those found in the prostate gland. Smoking raises the risk for developing more aggressive prostate cancer and recurrent cancer, and also increases the chances of dying from prostate cancer.

Can drinking cause prostate cancer?

No. Alcohol use can increase the risk for many types of cancer, but prostate cancer is not on this list.

Prostate cancer prevention

Adopting the following healthy habits may help prevent prostate cancer (and cancer in general), research shows.

  • Exercise regularly
  • Eat a healthy diet to maintain a healthy weight
  • Avoid fat from dairy products and red and processed meats 
  • Avoid sugar-sweetened drinks and highly processed food
  • Limit calcium intake to 1,200 milligrams per day
  • Eat more healthy fats from fatty fish and olive oil
  • Get additional nutrients from tomatoes, broccoli, cauliflower, soy-based foods and green tea
  • Don’t smoke and avoid heavy use of alcohol
  • Avoid overdosing on multivitamins
  • Avoid vitamin E supplements and folic acid supplements
  • Work to control blood pressure, blood sugar and cholesterol levels
  • Keep stress levels low

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Show references
  • American Urological Foundation (2020). Does Having More Ejaculations Lessen the Chance of Prostate Cancer? UrologyHealth Extra.
  • A, Wohlfahrt J, Melbye M (2020, January 1). Vasectomy and Prostate Cancer Risk: A 38-Year Nationwide Cohort Study. Journal of the National Cancer Institute, 112(1), 71–77.
  • Prostate Cancer Foundation (2018, December 27). The Connection Between Smoking and Prostate Cancer (Part One of Three).
  • M, Haddock KS, Reid R, Kupelnick B (2010). Smoking as a risk factor for prostate cancer: a meta-analysis of 24 prospective cohort studies. American journal of public health. 100(4), 693–701.
  • American Cancer Society (2020, June 9). Alcohol Use and Cancer.
  • Rider JR, Wilson KM, Sinnott JA, et al. (2016). Ejaculation Frequency and Risk of Prostate Cancer: Updated Results with an Additional Decade of Follow-up. European Urology, 70(6), 974–982.