The Epidemiology of Prostate Cancer
Prostate cancer presents several enduring challenges that continue to defy solution despite extensive research. It has long been known that prostate tumours become increasingly prevalent with age, so much so that their occurrence could be viewed as part of the normal ageing process, as the vast majority of men will develop them if they live long enough (Giles 2003). Importantly, the preponderance of prostate tumours is of low metastatic potential and of slow growth so, although the majority of older men zealously investigated will be found to have microscopically detectable tumours, most men will die with a prostate tumour rather than from one (Bostwick et al. 2004).
In a minority of cases prostate tumours become invasive and potentially lethal. The conundrum here, elegantly articulated by Boccon-Gibod (1996), is how to distinguish “tigers” from “pussycats”; i.e. how to identify at a curable stage the minority of lethal cancers from the majority of non-aggressive tumours. Answers to this question remain elusive. Schnell and Witte (this volume) focus on inherited aspects of susceptibility to aggressive prostate cancer.
KeywordsProstate Cancer Prostate Cancer Risk Advanced Prostate Cancer Beta Carotene Incident Prostate Cancer
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