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Lancet Oncol. 2014 Oct;15(11):e484-92. doi: 10.1016/S1470-2045(14)70211-6.

Prevention and early detection of prostate cancer.

Author information

  • 1Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK. Electronic address:
  • 2Centre for Cancer Prevention, Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK.
  • 3Division of Urologic Surgery, Barnes-Jewish Hospital, Washington University School of Medicine, St Louis, MO, USA.
  • 4Office of the Chief Medical Officer, American Cancer Society, Atlanta, GA, USA; Department of Hematology and Oncology, Emory University, Atlanta, GA, USA.
  • 5Department of Clinical Cancer Prevention, Cancer Prevention and Population Sciences, The University of Texas MD Anderson Cancer Center, Houston, TX, USA.
  • 6Molecular Pathology, Department of Urology, Innsbruck Medical University, Innsbruck, Austria.
  • 7Division of Cancer Genetics and Epidemiology, The Institute of Cancer Research, London, UK; Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK.
  • 8Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.
  • 9Urology, University of Oxford, Oxford, UK.
  • 10Medical School, King's College London, London, UK; Regional Cancer Center Uppsala Orebro and Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
  • 11School of Public Health and Preventive Medicine, Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, VIC, Australia.
  • 12Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Oxford, UK.
  • 13Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
  • 14Nuffield 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.
  • 15Department of Urology, Vienna University Medical School, Vienna, Austria.
  • 16Biological Chemistry, Public Health, and Epidemiology, School of Medicine, University of California, Irvine, CA, USA.
  • 17Academic Urology Unit, Royal Marsden NHS Foundation Trust, London, UK.
  • 18Prostate and Urologic Cancer Research Group, Division of Cancer Prevention, National Cancer Institute, Bethesda, MD, USA.
  • 19Department of Prostate Cancer Research, Institute of Pathology, University Hospital of Bonn, Bonn, Germany.
  • 20Director of Assay Development, IR2Dx Inc Moraga, CA, USA.
  • 21Urology, Radboud University Medical Center, Nijmegen, Netherlands.
  • 22Department of Urology, Kantonsspital St Gallen, St Gallen, Switzerland.
  • 23Urologie, Schön Klinik Nürnberg/Fürth & Urologie 24, Fürth, Germany.
  • 24Erasmus University and Erasmus Medical Centre, Rotterdam, Netherlands.
  • 25Department of Urology, University Hospital Tübingen, Tuebingen, Germany.
  • 26Department of Urology, Université Catholique de Louvain, Brussels, Belgium.
  • 27Center 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.
  • 28Division of Nutritional Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.


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.

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