Risk Factors

  • Elevated baseline prostate specific antigen (PSA) blood test1-7
  • Family history of prostate cancer6 and/or BRCA1/2 mutations8-12
  • African-American race6
  • Risk of developing prostate cancer increases with age13
  • Other prostate disease14
  • Lifestyle, including obesity and certain dietary choices15-19


  1. Capitanio U, Perrotte P, et al.  Population-based analysis of normal Total PSA and percentage of free/Total PSA values: results from screening cohort.  Urology. 2009.  Volume 73: Issue 6; pages 1323-1327.
  2. Chun F, Hutterer G, et al.  Distribution of prostate specific antigen (PSA) and percentage free PSA in a contemporary screening cohort with no evidence of prostate cancer.  British Journal of Urology International.  2007.  Volume 100: Issue 1; pages 37-41.
  3. Howard K, Barratt A, Mann G, Patel M.  A model of prostate-specific antigen screening outcomes for low- to high-risk men: information to support informed choices.  Archives of Internal Medicine.  2009.  Volume 169: Issue 17; pages 1603-1610.
  4. Lilja H, Cronin A, et al.  Prediction of significant prostate cancer diagnosed 20 to 30 years later with a single measure of prostate-specific antigen at or before age 50.  Cancer.  2011.  Volume 117: Issue 6; pages 1210-1219.
  5. Ulmert D, Cronin A, et al.  Prostate-specific antigen at or before age 50 as a predictor of advanced prostate cancer diagnosed up to 25 years later: a case-control study.  BMC Med.  2008.  Volume 6: Issue 6.
  6. Vertosick E, Poon B, Vickers A.  Relative value of race, family history and prostate specific antigen as indications for early initiation of prostate cancer screening.  J Urol.  2014.  Volume 192: Issue 3; pages 724-728.
  7. Vickers A, Ulmert D, et al.  Strategy for detection of prostate cancer based on relation between prostate specific antigen at age 40-55 and long term risk of metastasis: case-control study.  BMJ.  2013; Volume 346: f2023.
  8. Castro E, Goh C, et al.  Germline BRCA mutations are associated with higher risk of nodal involvement, distant metastasis, and poor survival outcomes in prostate cancer.  J Clin Oncol.  2013.  Volume 31: Issue 14; pages 1748-1757.
  9. Mitra A, Fisher C, et al.  Prostate cancer in male BRCA1 and BRCA2 mutation carriers has a more aggressive phenotype.  Br J Cancer.  2008.  Volume 98: Issue 2; pages 502-507.
  10. Narod S, Neuhausen S, et al.  Rapid progression of prostate cancer in men with a BRCA2 mutation.  Br J Cancer.  2008.  Volume 99: Issue 2; pages 371-374.
  11. Thorne H, Willems A, et al.  Decreased prostate cancer-specific survival of men with BRCA2 mutations from multiple breast cancer families.  Cancer Prev Res (Phila).  2011.  Volume 4: Issue 7; pages 1002-1010.
  12. Tryggvadóttir L, Vidarsdóttir L, et al.  Prostate cancer progression and survival in BRCA2 mutation carriers.  J Natl Cancer Inst.  2007.  Volume 99: Issue 12; pages 929-935.
  13. Warlick C, Weight C, Konety B.  Prostate Cancer in Older Adults.  2014.  Geriatric Urology.  Pages 273-288.
  14. Bostwick D, Cheng L.  Precursors of prostate cancer.  Histopathology.  2012.  Volume 60: Issue 1; pages 4-27.
  15. Arab L, Su J, Steck S, Ang A, Fontham E, Bensen J, Mohler J.  Adherence to World Cancer Research Fund/American Institute for Cancer Research lifestyle recommendations reduces prostate cancer aggressiveness among African and Caucasian Americans. Nutr Cancer.  2013.  Volume 65: Issue 5; pages 633-643.
  16. Su L, Arab L, Steck S, Fontham E, Schroeder J, Bensen J , Mohler J. Obesity and prostate cancer aggressiveness among African and Caucasian Americans in a population-based study.  Cancer Epidemiol Biomarkers Prev.  2011.  Volume 20: Issue 5; pages 844-853.
  17. Vance T, Wang Y, Su L, Fontham E, Steck S, Arab L, Bensen J, Mohler J, Chen M, Chun O.  Dietary Total Antioxidant Capacity is Inversely Associated with Prostate Cancer Aggressiveness in a Population-Based Study.  Nutr Cancer.  2016.  Volume 68: Issue 2; pages 214-224.
  18. Antwi S, Steck S, Su L, Hébert J, Zhang H, Fontham E, Smith G, Bensen J, Mohler J, Arab L.  Dietary, supplement, and adipose tissue tocopherol levels in relation to prostate cancer aggressiveness among African and European Americans: The North Carolina-Louisiana Prostate Cancer Project (PCaP).  Prostate.  2015.  Volume 75: Issue 13; pages 1419-1435.
  19. Vance T, Su J, Fontham E, Koo S, Chun O.  Dietary antioxidants and prostate cancer: a review.  Nutr Cancer.  2013.  Volume 65: Issue 6; pages 793-801.