Can BPH and prostate cancer be prevented?
Lifestyle modification, chemoprevention show benefits in some, not all randomized studies
Benign prostatic hyperplasia (BPH) and prostate cancer are two of the most common and costly diseases of older men (J Urol 2005; 173:1309-13; J Urol 2005; 173:1256-61; J Urol 2011; 186:971-6; CA Cancer J Clin 2016; 66:7-30; Curr Opin Urol 2013; 23:331-6). While timely diagnosis and appropriate treatment are important strategies for mitigating morbidity and mortality, BPH and prostate cancer are also potentially preventable.
There are three basic types of disease prevention: primary, secondary, and tertiary (figure). Primary prevention refers to the prevention of incident disease in at-risk populations. A common example is childhood immunization. Secondary prevention is reducing the burden of a disease through population screening and treatment of pre-clinical conditions. Examples include prostate-specific antigen (PSA) screening for prostate cancer and blood glucose screening for type 2 diabetes. Finally, tertiary prevention focuses on diminishing the risk of recurrence or progression in patients with clinical disease. An example is bacillus Calmette–Guérin (BCG) therapy after transurethral resection in patients with high-grade, nonmuscle-invasive bladder cancer.
This review focuses on primary prevention of BPH and prostate cancer.