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Prostate Cancer Methods and Protocols

Prostate cancer is the most common male cancer diagnosed in Western populations. Autopsy studies have shown that with increasing age, the majority of men will develop microscopic foci of cancer (often termed “latent” prostate cancer) and that this is true in populations that are at both high and low risk for the invasive form of the disease (1). However, only a small percentage of men will develop invasive prostate cancer. The prevalence of prostate cancer is, thus, very common; but to most men, prostate cancer will be only incidental to their health and death | M E T H O D S I N M O L E C U L A R ME D I CI N ETM Prostate rSr iCancerv Methods y -jg and Protocols Edited by v Pamela J. Russell XPaul Jackson Elizabeth A. kingsley Ị k u Humana Press 1 Epidemiological Investigation of Prostate Cancer Graham G. Giles 1. Introduction Prostate cancer is the most common male cancer diagnosed in Western populations. Autopsy studies have shown that with increasing age the majority of men will develop microscopic foci of cancer often termed latent prostate cancer and that this is true in populations that are at both high and low risk for the invasive form of the disease 1 . However only a small percentage of men will develop invasive prostate cancer. The prevalence of prostate cancer is thus very common but to most men prostate cancer will be only incidental to their health and death. Although much progress has been made in recent years in identifying risk factors for prostate cancer much more epidemiological research needs to be conducted combining molecular biology and genetics in population studies. We still need to answer the question what causes a minority of the common microscopic prostate cancers to grow and spread 2 . Until we have this answer we can do nothing to prevent life-threatening prostate cancer from occurring and many men will continue to be treated for prostate cancer perhaps unnecessarily. A major problem with past epidemiological studies of prostate cancer has been a lack of disease specificity most epidemiological studies combine all diagnoses of prostate cancer as if they are the same disease. Given the low metastatic and lethal potential of most prostate cancers the arbitrary grouping of all prostate cancers is destined to produce weak and inconsistent findings and such has been the history of prostate cancer epidemiology 2 . Since the 1990s the problem of disease specificity has worsened with the advent of prostate-specific antigen PSA testing and the detection of thousands of prostate cancers many of which .