Prostate Cancer Prevention in the Developing World - What are we Waiting for?

Karen      S. Bishop; Chi      Hsiu-Juei Kao; Dug      Yeo Han; Lynnette      R. Ferguson

doi:10.2174/1875692111201010070

Abstract

The field of personalized medicine is currently broadening in scope in at least three crucial dimensions. First, while genetics/genomics individual variability is an important aspect of personalized medicine, it is clear that environmental, nutritional, lifestyle and social risk factors play a crucial role for suboptimal therapeutics or disease susceptibility. Second, personalized medicine can inform not only drug therapy but also preventative medicine such that public health interventions that mitigate or prevent disease risks are also customized at an individual and subpopulation level. Third, personalized medicine is now truly global in scope demanding scholarship and innovation analysis beyond the developed countries. In this paper, we critically bring together these three emerging and broader strands of personalized medicine by focusing on prevention of prostate cancer in the developing world. Although prostate cancer prevalence used to be lower in developing countries in the past, this situation is beginning to change rapidly as people living in the developing world transition to a lifestyle more similar to that found in affluent countries. This transition to decreased physical activity, burgeoning overweight/obesity levels, changing nutritional habits, and greater consumption of tobacco, leads to an increased prevalence of non-communicable diseases. There are indications that these changes may also lead to an increase in prostate cancer in low and middle income countries (LMICs). We outline the risk factors associated with prostate cancer, some of the changes that are taking place in LMICs, the reasons behind these changes and the need for personalized or rationally targeted preventative interventions against prostate cancer in LMICs and globally.

Keywords: Developing countries, global personalized medicine, lifestyle risks, low and middle income countries (LMICs), nutrigenomics, personalizing preventive medicine, prostate cancer, risk assessment