Most prostate cancers don’t have a genetic link. However, in a small percentage of causes, certain mutations like those in the BRCA1 or BRCA2 gene can increase your risk.

Prostate cancer is the most common cancer in men. About 1 in 8 men will receive a diagnosis of prostate cancer in their life.

Most cases of prostate cancer develop in men without a family history, but a small percentage of prostate cancers have been linked to inherited genes. According to the American Cancer Society (ACS), having a brother or father with prostate cancer more than doubles your risk of developing it.

The risk is higher if you have a brother with prostate cancer than a father. The risk is highest if you have several relatives affected, especially if they developed prostate cancer at a young age.

In this article, we take a closer look at how genetics relate to the development of prostate cancer.

Language matters

In this article, we talk about the genetic risks of prostate cancer in people assigned male at birth.

It’s important to note that not everyone assigned male at birth identifies with the label “men.” However, at times we use “men” or “male” to reflect the language in a study or statistic, or to make sure people can find this article with the terms they search.

When possible, we aim to be inclusive and create content that reflects the diversity of our readers.

Was this helpful?

Estimates on the number of prostate cancers that are hereditary vary depending on how hereditary prostate cancer is defined.

One proposed definition for hereditary prostate cancer called the Hopkins Criteria classifies prostate cancer as hereditary if one of the following is true:

  • You have three or more first-degree relatives with prostate cancer, which includes children, parents, or brothers.
  • You have prostate cancer in three generations on either your mother’s or father’s side of the family.
  • You have at least two relatives with a diagnosis of prostate cancer before age 55.

Using these criteria, about 3% to 5% of prostate cancers are considered hereditary.

Genes linked to prostate cancer

The odds of a man developing prostate cancer in his life is about 11%, but certain mutations like those in the BRCA2 and HOXB13 genes can potentially raise your risk by as much as 2 to 10 times.

Up to 15% of men with stage IV prostate cancer have mutations in the genes BRCA1 or BRCA2, whereas, only about 5% to 7% of men with early stage prostate cancer carry these mutations. BRCA2 mutations are thought to increase your risk of prostate cancer eight times while BRCA1 mutations are thought to increase your risk three times.

Mutations in BRCA genes are seen in about 1 in 400 people in the general population but as many as 1 in 40 people of Ashkenazi Jewish ancestry.

According to the authors of a 2022 study published in the American Cancer Society Journals, analysis of the ongoing IMPACT clinical trial has found evidence that people carrying BRCA2:

  • have a high incidence of prostate cancer
  • receive a diagnosis at a younger age
  • are more likely to have advanced disease at the time of diagnosis

Other cancers linked to BRCA1 and BRCA2mutations

Mutations in BRCA1 and BRCA2 are also linked to:

Other mutations linked to prostate cancer

Mutations in the following genes have also been linked to an increased risk of prostate cancer:

  • MLH1
  • MSH2
  • MSH6
  • PMS2

Mutations in these genes are called Lynch syndrome.

Lynch syndrome has also been linked (across all sexes) to an increased risk of developing the following cancers before age 50:

Risk factors for prostate cancer include:

  • Age: Most men are over the age of 50 when they receive a diagnosis of prostate cancer.
  • Race: African American men have about twice the risk of developing and dying from prostate cancer as other men in the United States.
  • Diet: According to the ACS, some research suggests a diet high in dairy may slightly increase your risk of prostate cancer.
  • Obesity: Some research suggests obesity may be linked to a higher risk of advanced prostate cancer or dying from prostate cancer. However, being obese doesn’t seem to increase your overall risk.
  • Chemical exposure: Firefighters exposed to certain chemicals may be at an increased risk of prostate cancer. Some research suggests a potential link between prostate cancer and Agent Orange exposure, although a definitive link hasn’t been found.

Most of the time, doctors don’t know what causes prostate cancer. You can’t always prevent prostate cancers, and some risk factors are out of your control.

Research is mixed about whether being overweight or consuming a very high calcium diet increases your risk of prostate cancer. According to the ACS, the best preventative advice, for now, is to:

  • get to and maintain a moderate weight
  • stay physically active throughout your life
  • eat a balanced diet that includes lots of fruits and vegetables

Learn more about preventing prostate cancer.

Screening for prostate cancer in high risk people

If you carry genes associated with a higher risk of prostate cancer, regular screening may give you a better chance of detecting cancer in the early stages and treating it before it spreads.

The chances of a man with early stage prostate cancer surviving at least 5 years are about 99% compared with a man without prostate cancer. However, the chances drop to 31% if prostate cancer reaches distant organs.

Doctors usually screen for prostate cancer by measuring levels of an enzyme called prostate specific antigen (PSA) with a blood test or by performing a digital rectal exam.

Learn more about prostate cancer screening.

When to begin screening for prostate cancer

There are various schools of thought on when to start prostate cancer screening, but the consensus is that all men should first have an in-depth conversation with their doctors about the risks and benefits of screening.

The ACS recommends that the discussion about screening should take place 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 of developing prostate cancer (including African Americans and men with a father or brother with a diagnosis of prostate cancer before the age of 65)
  • age 40 for men with more than one first-degree relative (father or brother) with a diagnosis of prostate cancer before the age of 65

What age are you most likely to get prostate cancer?

About 60% of prostate cancers develop in men over the age of 65. The average age at the time of diagnosis is roughly 66. It’s rare to develop prostate cancer before the age of 40.

Where do most prostate cancers originate?

Almost all prostate cancers are classified as adenocarcinomas. These cancers develop in the cells that produce prostate fluid.

Can you live without a prostate?

You can live without a prostate, but some men experience problems after surgery like urinary incontinence or erectile dysfunction. It’s generally recommended to store sperm in a sperm bank if you still plan on having children.

How can I test to see if I have a gene mutation linked to prostate cancer?

You can test to see if you have a genetic mutation linked to prostate cancer by taking a blood or urine test.

The majority of prostate cancers aren’t linked to genetic factors. Mutations in some genes like BRCA1 and BRCA2 are linked to an increased risk of prostate cancer in a small percentage of cases.

You can find out if you carry genes associated with prostate cancer with a blood or urine test. If you do have genes associated with prostate cancer, your doctor may recommend starting screening at a younger age.