Prostate Cancer Risk: Who Is Most at Risk and What You Can Do to Reduce It

Prostate Cancer in the UK: Why Understanding Risk Matters

Prostate cancer is the most common cancer in men in the UK. Recent high-profile diagnoses, such as David Cameron and Chris Hoy, have encouraged many men to consider their own risk more seriously. Although prostate cancer is highly treatable when caught early, it often causes no symptoms at all until late in the disease. As a result, some men are diagnosed late, when treatment is more complex and success rates are lower.

There is currently no national screening programme for prostate cancer in the UK. Understanding your personal risk and knowing when to consider a PSA test is therefore essential.

Below is an evidence-based guide to prostate cancer risk factors and prevention.

What Is the Prostate and What Does It Do?

The prostate is a small, walnut-sized gland located at the base of the bladder. It surrounds the urethra (the urine passage from the bladder to the penis) and produces fluid that supports sperm in ejaculation.

The prostate can be affected by a range of conditions, including:

• Infection

• Inflammation

• Cancer

• Enlargement with age, known as benign prostatic hyperplasia (BPH)

By age 60, around half of all men will have BPH. It is the most common cause of urinary symptoms as men age, such as:

• Night-time urination

• Frequent daytime urination

• Difficulty starting urine flow

  
  

Importantly, BPH is not cancer, and most men with urinary symptoms have BPH rather than prostate cancer.

Who Is at Risk of Prostate Cancer?

Several factors increase prostate cancer risk:

1. Age

• Risk rises significantly after age 50

• Extremely rare before 50

• Over 50% of prostate cancers occur in men aged 70+

• Most common diagnosis age: 70–74

2. Family History

Risk increases if you have:

• A first-degree relative with prostate cancer

• A family history of breast cancer

• A BRCA2 mutation, which is associated with a higher prostate cancer risk

3. Black African or Caribbean Heritage

1 in 4 Black men will develop prostate cancer, almost double the risk compared with other ethnic groups

Reasons include:

• Genetic variants

• Differences in androgen receptor signalling

• Vitamin D deficiency

• Metabolic factors (obesity, insulin resistance)

• Dietary patterns

• Healthcare inequalities

• Chronic stress and racism

4. Lifestyle Factors

Risk increases with:

• Obesity

• Physical inactivity

• Diets high in ultra-processed foods

Physical activity has strong evidence for reducing the risk of aggressive prostate cancer.

Testosterone, Cycling and Other Common Questions

Testosterone & Testosterone Therapy (TTh)

Despite long-standing debate, large trials show no evidence that testosterone therapy increases prostate cancer risk. This is because the prostate becomes saturated with testosterone at around 8.5 nmol/L. Raising levels beyond this does not stimulate prostate receptors further.

Cycling

There is no evidence that cycling or pressure on the prostate increases prostate cancer risk.

Can Prostate Cancer Be Prevented?

Lifestyle Measures That Reduce Risk

Small, sustainable lifestyle changes can significantly reduce overall cancer risk, including:

• Physical activity

  • Two strength sessions per week

  • Plus 150 min moderate or 75 min vigorous aerobic activity

• Healthy weight management

• Mediterranean-style diet

  • Healthy fats

  • Fibre

  • Cruciferous vegetables

  • Lycopene (tomatoes)

• Limiting ultra-processed foods

Frequent Ejaculation

Some evidence suggests more frequent ejaculation may reduce prostate cancer risk, possibly by removing waste products from the prostate.

Factors You Cannot Change

These include:

• Age

• Genetics

• Ethnicity

If you're at higher risk due to these, understanding the potential benefits of screening becomes even more important.

FAQs

1. Is prostate cancer preventable?

You can’t prevent prostate cancer entirely, but lifestyle measures such as regular exercise, weight management, and a Mediterranean-style diet can reduce risk.

2. Does testosterone therapy increase prostate cancer risk?

No. Large trials show testosterone therapy does not increase prostate cancer risk. The prostate becomes saturated at around 8.5 nmol/L, and further increases do not stimulate prostate receptors.

3. Are urinary symptoms a sign of prostate cancer?

Not usually. Most urinary symptoms in ageing men are caused by benign prostatic hyperplasia (BPH), not cancer.

4. Why are Black men at higher risk?

Black African and Caribbean men have a higher risk due to a mix of genetic, metabolic, environmental, and structural factors — including differences in androgen signalling and healthcare inequalities.

5. Can frequent ejaculation reduce prostate cancer risk?

Evidence is mixed, but some studies suggest frequent ejaculation may help reduce risk.