Epidemiology + Aetiology

Question 1

What is prostate cancer epidemiology?

Answer 1

Ask questions of what? , who? , when?, and where?

Question 2

What is the typical prostate cancer age range in the uk?

Answer 2

75 - 79 years old

Question 3

What ethnicity has the most incidence rates of prostate cancer in the uk?

Answer 3

Black males → with 120.8 - 247.9 / 100,000

Question 4

What ethnicity has the lowest incidence rates in the uk?

Answer 4

Asian men → with 28.7 -60.6 /100,000

Question 4

What does the uk process study show about black males with prostate cancer compared to white males?

Answer 4

5 years younger and more likely to have a higher PSA than white males

Question 5

In 2020, what percentage of prostate cancers were diagnosed at stage 1?

Answer 5

29.7 %

Question 6

In 2020, what percentage of prostate cancers were diagnosed at stage 2?

Answer 6

13.3%

Question 7

In 2020, what percentage of prostate cancers were diagnosed at stage 3?

Answer 7

21 %

Question 8

In 2020, what percentage of prostate cancers were diagnosed at stage 4?

Answer 8

20.1 %

Question 9

What is the North/south divide?

Answer 9

National prostate cancer audit demonstrates → men in more deprived areas are more likely to be diagnosed at stage 4
Now palliative stage

Question 10

What is the purpose of men being encouraged to do online “risk checkers”?

Answer 10

To assess whether they’re showing / have prostate cancer symptoms

Question 11

What is prostate cancer morality?

Answer 11

The amount of deaths caused by prostate cancer per new case

Question 12

What is morality linked to?

Answer 12

To age (75 + years)

Question 13

What age range has the highest morality rate?

Answer 13

90 + years

Question 14

What is prostate cancer survival?

Answer 14

The rate of men who survive multiple years after diagnosis of the disease

Question 15

What percentage of men diagnosed with stage 1 and 2 survive 5 years or more?

Answer 15

100 %

Question 16

1in 2 men survive 5 or more years. What stage and percentage is this?

Answer 16

The latest stage at 49%

Question 17

What percentage of men survive their cancer 10 or more years?

Answer 17

78%

Question 18

What is prostate cancer pathology and natural history?

Answer 18

Prostate cancer can spread directly into nearby organs such as the bladder, rectum, and seminal vesicles

Question 19

What is lymphatic spread?

Answer 19

Initially to obturator, presacral, internal and external iliac nodes. Though further spread is to common iliac and paraaortic nodes.
Invasion into the pelvic veins, bones and vertebrae

Question 20

In what men with what Gleason score is prostate cancer more aggressive?

Answer 20

Younger men with higher Gleason scores

Question 21

What is prostate cancer aetiology?

Answer 21

Why? And how?

Question 22

What percentage of prostate cancers result from inherited factors?

Answer 22

5 -9%

Question 23

How much higher is the risk of getting prostate cancer if your father had it?

Answer 23

2.1 - 2.4 times higher

Question 24

How much higher is the risk of getting prostate cancer if a brother has/had it?

Answer 24

2.9 - 3.3 times higher

Question 25

How much higher is the risk of getting prostate cancer if a second - degree relative has/ had it?

Answer 25

1.9 times higher

Question 26

In what age group of men is familial prostate cancer a higher risk when more than one first degree relative is diagnosed?

Answer 26

< 65 years old

Question 27

How much does prostate cancer risk increase for men with BRCA 2 mutation?

Answer 27

5 x higher

Question 28

How much does prostate cancer risk increase for men with BRCA 2 mutation and < 65 years old?

Answer 28

7 x higher

Question 29

What is the percentage of increased risk of prostate cancer in men whose mother has/had breast cancer?

Answer 29

19 - 24% increase

Question 30

How much does the risk of prostate cancer increase in men with lynch syndrome?

Answer 30

2.1 - 4.9 x higher

Question 31

What is the link between BMI and prostate cancer?

Answer 31

The higher the BMI the more advanced the prostate cancer is

Question 32

Prostate cancer is estimated to be how much higher in European men with metabolic syndromes linked to obesity?

Answer 32

30% higher

Question 33

What is the increased risk percentage of dying from prostate cancer with every 5kg/m2 increase in BMI?

Answer 33

15 -20% increase

Question 34

How is diet linked to increased risk of prostate cancer?

Answer 34

Diet high in calcium and phosphorus (found in dairy )

Question 35

What foods according to the International Agency for Research on cancer are ‘limited/ probable evidence’ to increase prostate cancer risk?

Answer 35

Red meat

Question 36

What hormone causes 38 - 83 % increased risk of developing prostate cancer, but does not cause symptoms?

Answer 36

Higher levels of IGF -1

Question 37

What is the 'wingmen’ trial?

Answer 37

To test a new drug that blocks IGFs in men diagnosed with prostate cancer ( scheduled for prostatectomy)

Question 38

Is the evidence to show statistically significant increased risk of prostate cancer developed in men who are infertile or had a vasectomy?

Answer 38

Yes → evidence shows of a small but significant increase.

Question 39

What are environmental and occupational exposures that increases risk of prostate cancer?

Answer 39

Pesticides Arsenic Cadmium ( and compounds) Rubber production

Question 40

How do pesticides increase risk of prostate cancer?

Answer 40

Increased exposure → causes 33% increased risk

Question 41

How does arsenic increase risk of prostate cancer?

Answer 41

This is occupational exposure → through industrial use of arsenic IARC → Limited evidence

Question 42

How does cadmium (and componds) increase risk of prostate cancer?

Answer 42

Industrial exposure → occupational →manufacturing batteries, plastics and solar panels

Question 43

What is not a causative factor of prostate cancer but could be an environmental factor that causes increased risk?

Answer 43

Gamma radiation → Energy Authority exposure