3 risk factors for prostate cancerSunday, September 19, 2021
Prostate cancer is the commonest cause of cancer in Jamaica and the commonest cause of cancer-related deaths.
A report by Glover in 1998 suggested that Jamaica may have the highest rate worldwide with an incidence of 304 per 100,000 people. However, the Jamaica Cancer Registry reports a lower age-standardised incidence rate of 78 per 100,000 people more recently.
This high incidence rate is not only seen in here in Jamaica, but also across our sister countries in the Caribbean. In Barbados it is also the leading cause with an incidence rate of 160.4 per 100,000 people and with a high mortality rate of 63.2 to 101.6 per 100,000 people. In Trinidad, the incidence is reported as high as 103 per 100,000 people and similarly is the leading cause of cancer-related deaths. It therefore poses a significant impact on the quality of life and the health-care system on this side of the world.
A risk factor for a disease is anything related to a person that increases their chance of contracting the illness. A risk factor by itself doesn't usually cause cancer and some people with several risk factors may never develop cancer, whereas others with no known risk factors develop the disease. Being aware of your risk factors will help you make more informed lifestyle and health-related choices. The strongest risk factors for prostate cancer include age, race/ethnicity and family history. Other risk factors include genetics and environmental factors.
Today I will focus on three of the more common and established risk factors.
Prostate cancer is rare in men younger than 40, but the chance of having prostate cancer rises rapidly after age 50. About six in 10 cases of prostate cancer are found in men older than 65. Autopsy studies confirm that prostate cancer has a long induction period, and that many men have incipient lesions in their 20s and 30s. The recommended age for screening for prostate cancer in Jamaica is 40.
The risk of prostate cancer is approximately 60 per cent higher in African Americans than in whites. Mortality among African Americans is approximately double that of whites. This likely explains the pattern seen across Jamaica and the rest of the Caribbean with our men largely of African descent. However, evidence is conflicting as to whether this mortality difference is solely explained by differences in socio-economic status variables and stage at diagnosis, or whether an inherent difference exists between these racial/ethnic groups in the underlying biology of prostate cancer. It should be emphasised that biological explanations for these risk differences could involve genetic factors, environmental factors, or, more likely, an interaction between the two.
Epidemiological studies conducted as far back as the 1950s determined that having a first-degree relative (brother or father) with prostate cancer increased risk for an individual by approximately two to three-fold, on average. Risk is further increased by early age at onset in relatives and multiple relatives with the disease.
It should be noted that these established risk factors are all non-modifiable. You can't change your race or family whether you're 'toning' or not. Growing older is a gift not a predicament. We are a high-risk population, so the message once again is a healthy lifestyle (diet and exercise) is important but screening at the right time gives you the best chance of early diagnosis and cure.
Dr Jeremy Thomas is a consultant urologist. He works privately in Montego Bay, Savanna-La-Mar, and Kingston and publicly at Cornwall Regional Hospital. He may be contacted on Facebook and Instagram: @jthomasurology or by e-mail: email@example.com