Since prostate cancer began to attract more epidemiologic interest in the 1980s, numerous etiologic clues have been identified, and areas are now emerging as promising in the search for causes of prostate cancer. Besides genetic studies, exposures belonging to the broad categories of nutritional and hormonal factors are now being intensively investigated by epidemiologists. These areas are not mutually exclusive since dietary factors may act via hormonal pathways. Among nutritional factors, a protective effect of lycopene, selenium, vitamin E, and perhaps phytoestrogens and fish oil appear particularly promising, although no definite answers have yet emerged. Hormonal influences are also biologically plausible. While studies of steroid hormones, chiefly androgens, have not produced consistent results, a positive association between serum levels of IGF-1 and prostate cancer appears convincing.
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