title: Prevention and early detection of prostate cancer.
abstract: Prostate cancer is a common malignancy in men and the worldwide burden of this disease is rising. Lifestyle modifications such as smoking cessation, exercise, and weight control offer opportunities to reduce the risk of developing prostate cancer. Early detection of prostate cancer by prostate-specific antigen (PSA) screening is controversial, but changes in the PSA threshold, frequency of screening, and the use of other biomarkers have the potential to minimise the overdiagnosis associated with PSA screening. Several new biomarkers for individuals with raised PSA concentrations or those diagnosed with prostate cancer are likely to identify individuals who can be spared aggressive treatment. Several pharmacological agents such as 5α-reductase inhibitors and aspirin could prevent development of prostate cancer. In this Review, we discuss the present evidence and research questions regarding prevention, early detection of prostate cancer, and management of men either at high risk of prostate cancer or diagnosed with low-grade prostate cancer.
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK. Electronic address: j.cuzick@qmul.ac.uk.
authors.forename: Jack
authors.initials: J
authors.lastname: Cuzick
authors.affiliation: Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
authors.forename: Mangesh A
authors.initials: MA
authors.lastname: Thorat
authors.affiliation: Division of Urologic Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, St Louis, MO, USA.
authors.forename: Gerald
authors.initials: G
authors.lastname: Andriole
authors.affiliation: Office of the Chief Medical Officer, American Cancer Society, Atlanta, GA, USA; Department of Hematology and Oncology, Emory University, Atlanta, GA, USA.
authors.forename: Otis W
authors.initials: OW
authors.lastname: Brawley
authors.affiliation: Department of Clinical Cancer Prevention, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
authors.forename: Powel H
authors.initials: PH
authors.lastname: Brown
authors.affiliation: Molecular Pathology, Department of Urology, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Zoran
authors.initials: Z
authors.lastname: Culig
authors.affiliation: Division of Cancer Genetics and Epidemiology, The Institute of Cancer Research, London, UK; Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK.
authors.forename: Rosalind A
authors.initials: RA
authors.lastname: Eeles
authors.affiliation: Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Leslie G
authors.initials: LG
authors.lastname: Ford
authors.affiliation: Urology, University of Oxford, Oxford, UK.
authors.forename: Freddie C
authors.initials: FC
authors.lastname: Hamdy
authors.affiliation: Medical School, King's College London, London, UK; Regional Cancer Center Uppsala Orebro and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
authors.forename: Lars
authors.initials: L
authors.lastname: Holmberg
authors.affiliation: School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
authors.forename: Dragan
authors.initials: D
authors.lastname: Ilic
authors.affiliation: Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Key
authors.affiliation: Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: La Vecchia
authors.affiliation: Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK; Department of Surgery (Urology), Laboratory Medicine, and Medicine (GU-Oncology), Memorial Sloan-Kettering Cancer Center, New York, NY, USA; Department of Laboratory Medicine, Lund University, University Hospital UMAS, Malmö, Sweden.
authors.forename: Hans
authors.initials: H
authors.lastname: Lilja
authors.affiliation: Department of Urology, Vienna University Medical School, Vienna, Austria.
authors.forename: Michael
authors.initials: M
authors.lastname: Marberger
authors.affiliation: Biological Chemistry, Public Health, and Epidemiology, School of Medicine, University of California, Irvine, CA, USA.
authors.forename: Frank L
authors.initials: FL
authors.lastname: Meyskens
authors.affiliation: Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Lori M
authors.initials: LM
authors.lastname: Minasian
authors.affiliation: Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK.
authors.forename: Chris
authors.initials: C
authors.lastname: Parker
authors.affiliation: Prostate and Urologic Cancer Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.
authors.forename: Howard L
authors.initials: HL
authors.lastname: Parnes
authors.affiliation: Department of Prostate Cancer Research, Institute of Pathology, University Hospital of Bonn, Bonn, Germany.
authors.forename: Sven
authors.initials: S
authors.lastname: Perner
authors.affiliation: Director of Assay Development, IR2Dx Inc Moraga, CA, USA.
authors.forename: Harry
authors.initials: H
authors.lastname: Rittenhouse
authors.affiliation: Urology, Radboud University Medical Center, Nijmegen, Netherlands.
authors.forename: Jack
authors.initials: J
authors.lastname: Schalken
authors.affiliation: Department of Urology, Kantonsspital St Gallen, St Gallen, Switzerland.
authors.forename: Hans-Peter
authors.initials: HP
authors.lastname: Schmid
authors.affiliation: Urologie, Schön Klinik Nürnberg/Fürth & Urologie 24, Fürth, Germany.
authors.forename: Bernd J
authors.initials: BJ
authors.lastname: Schmitz-Dräger
authors.affiliation: Erasmus University and Erasmus Medical Centre, Rotterdam, Netherlands.
authors.forename: Fritz H
authors.initials: FH
authors.lastname: Schröder
authors.affiliation: Department of Urology, University Hospital Tübingen, Tuebingen, Germany.
authors.forename: Arnulf
authors.initials: A
authors.lastname: Stenzl
authors.affiliation: Department of Urology, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Bertrand
authors.initials: B
authors.lastname: Tombal
authors.affiliation: Center for Chronic Disease Outcomes Research, Minneapolis Veterans Affairs Health Care System, and Section of General Medicine, University of Minnesota School of Medicine, Minneapolis, MN, USA.
authors.forename: Timothy J
authors.initials: TJ
authors.lastname: Wilt
authors.affiliation: Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Alicja
authors.initials: A
authors.lastname: Wolk
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000032:analysis; D001707:Biopsy, Needle; D055088:Early Detection of Cancer / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D007150:Immunohistochemistry; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology; D011322:Primary Prevention / Q000379:methods; D011379:Prognosis; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000517:prevention & control* / Q000628:therapy*; D012307:Risk Factors; D040242:Risk Reduction Behavior
chemical_list: D014408:Biomarkers, Tumor; D017430:Prostate-Specific Antigen