Prostate cancer is malignant neoplasm, most commonly adenocarcinoma; sarcomas and small cell cancers are rarely observed. It is the most common noncutaneous cancer affecting men, with over 1 million new cases diagnosed annually. Incidence of prostate cancer rises with age, with approximately 11% of men in the United States diagnosed at some point in their life. The mortality rate is approximately 20%. Affected patients are asymptomatic until the disease has reached an advanced stage. Screening with prostate-specific antigen (PSA) reveals abnormalities in the serum and assists in early diagnosis.

Most prostate cancers are identified at the local stage through annual screenings, and the majority of patients are asymptomatic at that stage. At later stages, physical findings may include perineal pain and urinary changes (eg, frequency, retention, nocturia). Urinary changes in men are more frequently the result of benign prostate conditions, which are sometimes found as comorbidities. Physical examination may reveal areas of induration, asymmetry, and/or prostate nodule. Diagnosis is confirmed via prostate biopsy.

Risk factors include advancing age, family history, obesity, poor diet, elevated insulin levels, and vitamin E supplementation. Disease is more common in individuals of African descent. Individual susceptibility genes are now being identified. Men with BRCA mutations, primarily BRCA2 mutations, are at increased risk of prostate cancer. Treatment depends on the level of risk and the age of the patient.

If cancer has spread, physical findings may include bone pain or pathologic fracture. See metastatic prostate carcinoma.