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Prostate cancer causes and risk factors

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science at CTCA.

This page was updated on August 19, 2022.

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. Understanding the risk factors may help men take preventive measures to reduce the likelihood of developing prostate cancer.

Top risk factors for prostate cancer and how they affect your risk
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Risk factors you can’t control

Age: The risk of developing prostate cancer increases with age. One in 10,000 men younger than 40 will be diagnosed with prostate cancer, but one in 15 men in their 60s will be 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.

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 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.

Common questions about the causes of prostate cancer

Can masturbation or frequent sex cause prostate cancer?

Masturbation or frequent sex don’t cause prostate cancer. In fact, it’s possible that 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 frequent ejaculation may 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 every cell in the body, including those found in the prostate gland. Smoking raises the risk of 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.

Risk factors you can control

The evidence for prostate cancer prevention (and cancer prevention in general) suggests adopting these habits:

  • 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 A
  • void overdosing on multivitamins
  • Avoid vitamin E supplements and folic acid supplements
  • Work to control blood pressure, blood sugar and cholesterol levels
  • Keep your stress level low

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Show references
  • American Urological Foundation (2020). Does Having More Ejaculations Lessen the Chance of Prostate Cancer? UrologyHealth Extra.
    https://www.urologyhealth.org/healthy-living/urologyhealth-extra/magazine-archives/fall-2020/ask-the-experts-does-having-more-ejaculations-lessen-the-chance-of-prostate-cancer
  • 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.
    https://pubmed.ncbi.nlm.nih.gov/31119294/
  • Prostate Cancer Foundation (2018, December 27). The Connection Between Smoking and Prostate Cancer (Part One of Three).
    https://www.pcf.org/c/the-connection-between-smoking-and-prostate-cancer/
  • 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.
    https://doi.org/10.2105/AJPH.2008.150508
  • American Cancer Society (2020, June 9). Alcohol Use and Cancer.
    https://www.cancer.org/cancer/cancer-causes/diet-physical-activity/alcohol-use-and-cancer.html#:~:text=Alcohol%20use%20is%20one%20of,deaths%20in%20the%20United%20States
  • 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.
    https://doi.org/10.1016/j.eururo.2016.03.027