Primary prevention

There is no formal primary prevention program in the US.

Most cases of prostate cancer cannot be prevented. However, risk may be reduced by addressing lifestyle factors, such as poor diet and being overweight.

Chemoprevention

The role of 5-alpha-reductase inhibitors in preventing prostate cancer has been investigated, but remains controversial. Chemoprevention with finasteride and dutasteride reduces risk of prostate cancer by approximately 20% to 25%.[37][38]​ Long-term analyses found continued risk-reduction benefit in those treated with finasteride.[39][40]​​ However, concerns exist about increased risk of high-grade tumors.

One population-based cohort study reported that men treated with 5-alpha-reductase inhibitors for >2 years had a decreased risk of prostate cancer mortality compared with men who did not receive treatment. However, the men receiving treatment underwent more prostate-specific antigen (PSA) testing and biopsies than the unexposed group, which may have had an impact on the survival difference.[41]​ No statistically significant differences were seen in all-cause mortality.

The impact of 5-alpha-reductase inhibitors on absolute or relative rates of prostate cancer in men who are not being regularly screened is not clear. 5-alpha-reductase inhibitors suppress PSA levels, which may lead to misinterpretation of PSA values and possible delays in diagnosis and poorer outcomes.[42] 

Low-fat diet

A low-fat diet may help reduce the risk of developing prostate cancer. In one systematic review and meta-analysis of randomized and observational studies, soy foods and their isoflavones (genistein and daidzein) were significantly associated with a reduced risk of prostate cancer.[43] Limitations of the review, for example inclusion of studies that rely on dietary recall and presence of potentially confounding variables, necessitate interpreting the results with caution. Further research is required.

Vitamins and dietary supplements

There is no evidence that vitamin supplements C and E or selenium reduce the risk of prostate cancer.[44][45][46][47][48] [ Cochrane Clinical Answers logo ] ​ Similarly, multivitamins have not been shown to reduce the risk of prostate cancer.[49] Well-designed trials are warranted to expand knowledge, replicate findings, and further assess the impact of diet and dietary supplement interventions on recurrence and treatment-associated morbidities.[50]

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