Commonest cancer in men
No known modifiable risk factors
Prostate cancer is the commonest cancer and the second most common cause of cancer death for men in the UK, yet there are no known modifiable risk factors to inform prevention. We lead three large prostate cancer consortia and are using recent developments in high-throughput technologies to provide detailed information on novel biomarkers and metabolic profiles, combined with tumour phenotype, to examine a wide range of molecular and clinical factors that may influence the development of high risk prostate cancer. Through a co-ordinated programme of analyses we aim to advance understanding of the aetiology of aggressive prostate cancer and provide the platform needed for the development of evidence-based strategies for prostate cancer prevention.
Currently there is no evidence-based advice that men can be given to reduce their risk of prostate cancer. Risk is associated with age, ethnic origin, family history and inherited genetic variation, but these factors are not modifiable. Among potential environmental, lifestyle and metabolic risk factors for prostate cancer, we have shown that the strongest evidence is for a positive association with serum concentrations of insulin-like growth factor-1 (is it possible to link to these papers? IGF-1; Roddam et al 2008; Price et al 2012). Our research is focused on following-up on this lead with comprehensive studies of this metabolic pathway, but also on identifying any other potentially modifiable risk factors. Some prostate cancers have an excellent prognosis but others are very aggressive, and it is essential for future research to characterise tumour phenotype in detail and stratify analyses to establish risk factors for clinically significant disease.
We lead three large-scale consortia of epidemiological studies of prostate cancer.
• The EPIC-Prostate consortium includes 150,000 men in eight European countries participating in the European Prospective Investigation into Cancer and Nutrition (EPIC); participants were recruited between 1992 and 2000, so that average follow-up is now approaching 20 years and there will soon be more than 7,500 incident cases of prostate cancer.
• In the UK Biobank Prostate Cancer Epidemiology Consortium, our analyses of prostate cancer risk are based on the data from the 230,000 men in the cohort, with 5,000 incident cases expected by 2018.
• We established the Endogenous Hormones, Nutritional Biomarkers and Prostate Cancer Collaborative Group in 2005, an international consortium for conducting collaborative analyses of individual participant data from all eligible prospective studies worldwide of hormonal, nutritional and metabolic biomarkers and prostate cancer risk. There are currently 33 studies collaborating, including over 20,000 prostate cancer cases and over 90% of all the data in the world on these biomarkers.