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Age, Family History, and Ethnicity: The Real Determinants of Prostate Cancer Risk

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Prostate cancer has once again captured global attention following the recent diagnosis of former US President Joe Biden, shining a spotlight on a disease that is the most common cancer among men worldwide. While headlines often tout new prevention measures or promising lifestyle tweaks, leading experts have clarified that the factors most responsible for a man’s risk of developing prostate cancer lie largely beyond individual control: age, ethnicity, and family history. This evidence-based perspective, backed by the latest research, has vital implications for men in Thailand, where rising cancer rates are signaling the need for smarter screening and public health strategies.

For decades, Thai men have seen prostate cancer gradually move up the ranks of the nation’s cancer burden. According to the International Agency for Research on Cancer, the annual incidence in Thailand was 7.6 cases per 100,000 men in 2022, markedly lower than in Europe or North America but slowly climbing each year (GCO Thailand Fact Sheet). As medical infrastructure and longevity improve, physicians in Thailand are diagnosing prostate cancer earlier, with national projections showing the number of new cases expected to double by 2040 (ScienceDirect, 2025).

But not all prostate cancers are created equal—or equally dangerous. According to Dr. Hayley Luxton, head of research impact and engagement at Prostate Cancer UK, “There are essentially two types of prostate cancer: the ‘pussycats’ which grow so slowly they never threaten life, and the ‘tigers’—aggressive cancers that need urgent treatment.” In fact, autopsy studies reveal that more than half of men over the age of 90 have prostate cancer cells, most of which never caused symptoms or required treatment (Science Focus, 2025). Dr. Cody Watling, a postdoctoral fellow at the US National Cancer Institute, concurs: “Most men eventually will have prostate cancer cells. But whether that becomes clinically significant—whether it causes symptoms or spreads—is another matter entirely.”

The consensus from the scientific community points to three main, largely immutable, risk factors for developing—and dying from—prostate cancer: advanced age, Black ethnicity, and a family history of the disease. Aging is the single biggest risk, with most diagnoses occurring after age 70. A history of prostate, breast, or ovarian cancer in close relatives, especially those diagnosed before 60, dramatically raises risk, especially if gene mutations such as BRCA2 are involved (Wikipedia). While Black men face twice the risk of developing prostate cancer compared to white men, the underlying reasons—possibly genetic—remain unclear; existing data from Thailand show no similar pronounced ethnic disparities, but local studies are limited.

The role of lifestyle in prostate cancer risk is far less conclusive than many assume. “A lot of research has been done to try to disentangle if there are modifiable risk factors for prostate cancer,” said Dr. Watling, who has conducted extensive studies at the University of Oxford. “And to date, nothing has really shown strong evidence.” There are hints that high dairy intake—particularly milk—might slightly increase risk, possibly due to increased levels of a growth factor called IGF-1. However, experts stress that the effect is marginal and the evidence remains “hazy,” requiring much more robust studies before any dietary guidelines can be issued (Science Focus, 2025).

Perhaps the only lifestyle factor backed by a modest amount of evidence is body weight. Being overweight might increase the risk of “aggressive or fatal” prostate cancer. Yet even here, it is hard for scientists to separate the biological effects of obesity from the likelihood that overweight men are less likely to be screened early, thus presenting with more advanced disease. Both Dr. Luxton and Dr. Watling advise that while maintaining a healthy weight and regular exercise cannot eliminate a man’s risk, these habits are still valuable for reducing the severity of cases and for combating other serious illnesses.

Screening and early detection remain the only viable strategies for reducing prostate cancer mortality. Recent news coverage in the region has emphasized the importance of medical checkups, with Thai opinion pieces calling attention to how high-profile cases—like President Biden’s—can motivate men to seek lifesaving screening (Bangkok Post, 2025). In Thailand, research suggests that increased rates of prostate cancer screening have already contributed to a decrease in mortality (medRxiv, 2024).

The practical takeaway for Thai men is clear. If you are aged over 50, or over 45 with a family history of prostate, breast, or ovarian cancer, it is time to consult a doctor about your risk and discuss screening options such as the PSA blood test, digital rectal examination, or targeted MRI scans where available. In Thailand, as elsewhere, “you can use online risk checkers from reputable organizations as a first step—but always follow up with a healthcare professional for tailored advice,” says a leading urologist from a top Bangkok hospital.

Thailand’s medical community is also responding to developments in prostate cancer treatment. The introduction of new therapies for advanced, castration-resistant prostate cancer has improved survival rates in neighboring Japan and offers hope for Thai patients as these drugs become more widely available (PubMed, 2025). Additionally, ongoing studies in Thailand are refining the balance between active surveillance—where slow-growing “pussycat” tumors are simply monitored rather than aggressively treated—and intervention, minimizing harms from unnecessary procedures.

From a cultural perspective, discussions of prostate cancer in Thai society have historically been subdued, partly due to stigma surrounding male reproductive health. But as the population ages, breaking down these barriers is now recognized as a public health priority. Drawing from Buddhist principles of self-awareness and community support, Thai men are being encouraged to speak openly with both family and healthcare providers about symptoms, risk, and screening—mirroring the proactive, dialogue-driven approach seen in other successful cancer campaigns locally.

Looking to the future, Thailand’s growing burden of prostate cancer will demand not only improved hospital infrastructure but also smarter public health messaging to clarify risk factors and counter myths. Although lifestyle cannot “eliminate” prostate cancer risk, promoting healthy, active living alongside regular checkups can help identify the dangerous “tigers” before they spread. Meanwhile, genetic counseling and family history assessments are likely to take on a more prominent role in risk stratification as local genomic studies progress.

For Thai readers, the most effective and actionable response is twofold: first, to understand that, despite media noise, most prostate cancer risk is driven by age, family history, and, to a less certain degree, ethnicity—not diet or exercise alone; and second, to make regular screening a part of men’s health routines, especially for those in higher risk categories. By fostering open dialogue and prioritizing evidence over hype, Thai society can ensure that more men live long, healthy lives—no matter how headlines change.

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Medical Disclaimer: This article is for informational purposes only and should not be considered medical advice. Always consult with qualified healthcare professionals before making decisions about your health.