Prostate cancer is one of the most common cancers among men, according to the American Cancer Society, and the risk for developing it increases with age. Age is considered a risk factor because the prostate and the way its cells grow, repair themselves, and respond to hormones can all change over time. A combination of these changes helps explain why prostate cancer is more likely to develop later in life.

This article explains why the risk of prostate cancer increases with age and shares steps you can take to protect your health as you get older.

How Are Prostate Cancer Rates Affected by Age?

Prostate cancer rarely appears in young adults. Instead, the number of cases rises sharply with age, especially after age 50. According to the American Cancer Society, around 60 percent of prostate cancers are found in men over the age of 65. In those under 40, prostate cancer is extremely rare.

Racial and Ethnic Differences by Age Group

Although the risk of prostate cancer increases with age, some populations in the United States are diagnosed at higher rates and earlier in life. According to data from the National Cancer Institute’s Surveillance, Epidemiology, and End Results (SEER) Program and summarized by the American Cancer Society:

• Black men have higher incidence (new diagnoses) and mortality (death) rates across most age groups compared to other racial and ethnic groups, and they tend to be diagnosed at younger ages.
• Prostate cancer occurs less often in Asian/Pacific Islander and Hispanic men than in non-Hispanic white men.
• In all groups, both incidence and mortality increase with age.

These reasons for the disparities in prostate cancer rates in the United States are not fully understood. The increased risk in certain groups is thought to be due to a combination of factors, including:

• Genetics
• Environment
• Access to care
• Social stressors

However, these are patterns seen in large groups. Individual risk can be different. Talk with your doctor about your personal risk for prostate cancer, considering your full health history and background.

Why Age Increases Prostate Cancer Risk

Getting older does not directly cause prostate cancer, but several changes that happen in the body over time can increase the risk. These include genetic changes that build up over time, lifelong exposure to hormones, and chronic inflammation that affects the health of prostate cells.

Genetic Changes Build Up Over Time

Every cell in your body contains DNA, which acts like a set of instructions that tells cells how to grow and work. Over many years, your cells keep dividing to make new cells. Each time a cell divides, small changes called mutations (or copying errors) can happen in the DNA.

Most mutations are harmless, but some can affect genes that control how cells grow and divide. If enough harmful mutations build up over time, prostate cells may start to grow out of control, which can lead to cancer. Because these changes add up slowly, prostate cancer is much more likely to develop as people get older.

Hormone Levels Shift With Age

Hormones play a major role in how the prostate grows and functions. Testosterone and its more active form, dihydrotestosterone (DHT), help regulate the growth of prostate cells. As people age, testosterone levels tend to gradually decline. This shift in hormone levels can affect the prostate in several ways.

Lower testosterone levels may shift the balance toward more DHT activity, which may stimulate the growth of prostate tissue. Hormonal changes and imbalances can also make prostate cells more likely to grow in abnormal ways.

Hormones alone do not cause prostate cancer, but their long-term effects on the prostate gland can increase a person’s risk over time.

Chronic Inflammation Becomes More Common

Inflammation is the body’s natural response to injury or infection. But when inflammation occurs over the course of decades (called chronic inflammation), it can damage healthy cells.

As people get older, chronic inflammation becomes more common throughout the body, including in the prostate. This can be caused by:

• Repeated infections
• Urinary problems
• Diet and lifestyle factors
• Age-related changes to the immune system

Inflammation can directly damage prostate cells and may make harmful genetic changes more likely to form over time. Some early studies suggest that people who regularly take anti-inflammatory drugs, like aspirin, acetaminophen, and ibuprofen, may have less inflammation in the prostate linked to cancer risk.

The Prostate Grows With Age

Another natural change associated with aging is prostate enlargement, often called benign prostatic hyperplasia (BPH). It affects most men by the time they’re in their 60s, according to research in the Indian Journal of Urology.

BPH is not cancer, nor is it a risk factor for prostate cancer. However, there is a large overlap of people with BPH and people with prostate cancer. This is likely due to their shared risk factors, including genetic, hormonal, and inflammatory changes.

BPH and prostate cancer are separate conditions, but both are strongly linked to aging, even though most people with BPH don’t develop prostate cancer.

Changes in the Body’s Repair Systems

As people age, the body becomes less efficient at repairing damaged tissue. DNA repair becomes slower, the immune system weakens, and it becomes harder to remove abnormal cells before they develop into cancer.

This decreased repair capacity is seen in many cancers that are more common in older adults. In prostate cancer, weakened repair systems allow abnormal cells to survive longer and multiply.

Other Risk Factors That Add to Age

Although age is one of the strongest risk factors for developing prostate cancer, others can increase the likelihood as well.

• Family history and genetics — Having a father or brother with prostate cancer more than doubles a person’s risk of developing prostate cancer.
• Inherited gene mutations — Mutations in genes like BRCA1, BRCA2, or HOXB13 can raise risk.
• Lifestyle factors — Diet, obesity, smoking, and lack of physical activity contribute to risk, but the links are less clear.
• Environment — Long-term exposure to chemicals, like arsenic, can play a role.

In addition to age, these factors may continue to increase risk for prostate cancer development.

How To Take Care of Yourself as You Age

Growing older is a natural part of life. While prostate cancer risk does increase with age, there are steps you can take to protect your health. Being proactive can help you catch prostate problems early.

Talk to Your Doctor About Prostate Cancer Screening

Screening is one of the most important ways to stay ahead of prostate cancer. However, there is no one set of universal guidelines. Screening should be a shared decision between you and your doctor.

Screening usually includes the prostate-specific antigen (PSA) blood test, and can also include a digital rectal exam (DRE).

The American Cancer Society recommends that men discuss prostate cancer screening with their healthcare provider, taking into account possible benefits, risks, and uncertainties. The conversation about screening should happen at:

• Age 50 for men who are at average risk of prostate cancer and expected to live at least 10 more years
• Age 45 for men at high risk, including African American men and those with a father or brother who had prostate cancer at a younger age (under 65)
• Age 40 for men at even higher risk, such as those with more than one first-degree relative (father or brother) who had prostate cancer at a younger age

Your doctor can help you understand your individual risk and make an informed decision about whether and when to be screened. Early screening cannot prevent prostate cancer, but early detection can help your care team find cancer sooner, treat it earlier, and improve survival rates.

Manage Chronic Health Conditions

Conditions like diabetes, obesity, and high blood pressure may become more common with age. These conditions may influence hormonal level, inflammation, or overall health and have been found to be associated with more aggressive forms of prostate cancer.

Keeping them under control can help lower inflammation and improve your general well-being. Follow your doctor’s recommendations, take medications as prescribed, and keep up with your routine checkups.

Maintain Healthy Lifestyle Habits

Healthy living can’t eliminate your risk for prostate cancer, but it can help lower inflammation, support your immune system, and improve your recovery if you ever need treatment. Consider focusing on:

• Eating a balanced diet
• Getting regular exercise
• Limiting alcohol
• Avoiding or quitting smoking
• Maintaining a healthy weight

These habits may also improve prostate health and reduce your risk for other diseases. If you have questions or need support making changes, ask your doctor for guidance or a referral to a registered dietitian or lifestyle counselor.

Know Symptoms To Watch Out For

Prostate cancer often causes no symptoms in the early stages, which is why screening is important. As cancer grows, symptoms may include:

• Difficulty urinating
• A weaker urine stream
• Blood in the urine or semen
• Pain in the back or pelvis

If you notice any new or unusual symptoms, tell your doctor.

Join the Conversation

On MyProstateCancerTeam, people share their experiences with prostate cancer, get advice, and find support from others who understand.

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