Background: Compelling evidence indicates that environmental and life-style factors, in addition to well-known risk factors such as testosterone level and age, are important for the development of prostate cancer.
Methods: In this review we summarize up-to-date knowledge about carcinogenesis in the prostate. The review is based on our own clinical research experience in this field and relevant articles identified by a literature search in the Medline and PubMed databases.
Results: During carcinogenesis of the prostate, significant changes are consistently observed in several molecular pathways. These molecular pathways are possible targets for intervention directed at reversing, stopping, or delaying cancer development. Racial differences indicate that genetic factors are also important for the development of prostate cancer. Improved surrogate biomarkers are needed for appropriate initiation of therapy and in order to monitor response.
Interpretation: Prostate cancer might be targeted early in the course of the disease provided that suitable markers reflecting carcinogenesis are identified.