If My Dad Has Prostate Cancer, Will I Get It?

Having a father with prostate cancer raises your own risk, but it is far from a guarantee. Prostate cancer is common in older men overall, so the extra risk adds to an already sizable baseline instead of making cancer certain. How old your dad was at diagnosis, and who else in the family is affected, changes how much it matters for you.

How Much Your Father’s Diagnosis Raises Your Risk

A father, brother or son is called a first-degree relative, and having one with prostate cancer roughly doubles to 2.5 times your risk.¹ For a father specifically, the figure is about 2.1 times.² The increase covers the deadly kind too, at about 1.7 times higher.³

That number compares you with men who have no family history. It is not your personal chance of getting cancer, so “twice the risk” does not mean a 50% chance. A doubled small risk at age 50 is still a small risk, because lifetime risk climbs mostly after 65. Most sons of affected fathers never develop prostate cancer.

The increase of two to threefold applies to Black, white and Asian men alike.⁴ In Black men, having an affected father was linked to about 3 times the risk.⁵ Since Black men already face higher risk, those with an affected father carry two separate risk factors at once.

Families share habits and environments as well as genes, though inherited factors are thought to explain much of the pattern.

Your Dad’s Age and Other Relatives Change the Picture

Men whose father was diagnosed before 65 had about four times the expected rate of prostate cancer.⁶ The extra risk shrinks steadily the older the father was at diagnosis.⁷ The lowest added risk, about 1.8 times, was seen in men aged 65 to 74 with only an affected father.⁸ A father diagnosed in his late 70s or 80s is a weaker signal, but it still counts as family history worth mentioning to your doctor.

An affected brother raises risk more than an affected father, about 2.9 times.⁹ Risk climbs with every additional affected relative.¹⁰ Among Black men, two or more affected fathers or brothers meant more than 5 times the risk.¹¹ In the most extreme case, men under 65 with three affected brothers had about 23 times the risk.¹² An uncle or grandfather with the disease raises risk only somewhat, about 1.9 times.¹³

Women in the family count too. A mother or sister with breast cancer is linked to a modestly higher prostate cancer risk, about 1.2 times for a mother.¹⁴ For a sister, it was about 1.7 times.¹⁵ Breast cancer diagnosed before 60 in a female relative carried a higher prostate risk.¹⁶

Relatives on your mother’s side count as well, since genes pass through both parents. It’s worth asking your dad exactly how old he was when diagnosed and whether his cancer was aggressive or spread. Find out about brothers, uncles and grandfathers on both sides, and note any breast, ovarian, pancreatic or colon cancer in relatives, with their ages. Put it all in a simple family tree: each affected relative, the type of cancer and the age at diagnosis, with your mother’s and father’s sides both included. Keep it on your phone so it’s ready at appointments.

Inherited Gene Changes That Raise Risk Sharply

BRCA2 is a gene best known for breast cancer, but men who inherit a harmful change in it face sharply higher prostate cancer risk.¹⁷ Male carriers have about a 27% chance of prostate cancer by 75 and about 60% by 85.¹⁸ Their cancers tend to be more aggressive, with about 3.9 times the risk of dying of it.¹⁹ A harmful BRCA1 change raises risk less, up to about 3.8 times.²⁰

A HOXB13 gene change, mostly in families of European descent, appears in about 5% of families with several prostate cancers.²¹ Lynch syndrome, an inherited condition best known for raising colon cancer risk, gives men about a 38% chance of prostate cancer by 75.²²

A father with a harmful gene change has a 50% chance of passing it to each child, so you may or may not have inherited it. Most men with a family history are not carriers, which makes a test a question to ask rather than something to assume.

Several clues make a single gene more plausible:

Several relatives on the same side with prostate cancer, especially if some were diagnosed before 55.
Breast or ovarian cancer in women on that side, alongside prostate cancer in men, which points toward BRCA changes.
Pancreatic cancer, or colon cancer at a young age, in relatives.
A relative already found to carry a BRCA or Lynch syndrome change, which makes the question much more pressing for you.

Genetics isn’t only about single genes. Many common gene variants each add a little risk, and a combined genetic score can show who is at higher risk.²³ Such a score can identify higher-risk men even when no relative has had prostate cancer.²⁴

Should You Get Genetic Testing

Guidelines recommend gene testing for men with prostate cancer that has spread or is high-risk, regardless of family history.²⁵ Testing is also advised for men with relatives who had early breast, colon or uterine cancer, or ovarian or pancreatic cancer.²⁶ Family history alone misses many carriers: over a third of men with prostate cancer carrying a harmful change wouldn’t have qualified under older family-based rules.²⁷ So ask whether your father has been tested, since his result is the clearest guide for you.

A harmful change in him tells you exactly what to look for in yourself. If he hasn’t been tested, you can encourage him to ask his cancer team, especially if his cancer has spread or is high-risk. If he has died or doesn’t want testing, you can still raise your family history with your own doctor, who may refer you for counseling.

The first person tested usually has a panel that looks at many genes at once, typically from a blood or saliva sample. If he carries a harmful change, you are tested only for that specific change, which is simpler and more precise. A genetic counselor explains what results mean for you, your brothers and your own children, before and after testing. If you test negative for the change your father carries, your risk from that gene returns close to average, though ordinary family history still counts.

Even when one person tests positive, relatives often don’t follow up, citing fear and lack of insurance.²⁸ Cost and insurance impact are common worries about genetic testing.²⁹ In the US, the GINA law bars health insurers and employers from using genetic results against you, though it doesn’t cover life insurance.

When to Start Screening

A man with one affected first-degree relative reaches the serious-cancer risk of an average 50-year-old by about 46.³³ With two or more affected relatives, that point arrives at about 41.³⁴ Men with family history also tend to be diagnosed about five years younger.³⁵

The PSA test is a blood test measuring a protein made by the prostate. High levels can signal cancer, but also an enlarged prostate or infection. For men with high-risk gene changes, MRI scans found serious cancers that PSA missed.³⁶ If you carry a gene change, ask whether MRI should be part of your checks.

At a first visit, your doctor will ask about family history, so bring your family tree with ages at diagnosis. The PSA blood test takes only minutes at a normal blood draw, and you don’t need to fast. Ejaculation and hard cycling can nudge PSA up, so avoid them for a day or two beforehand. One high result usually leads to a repeat test, and possibly other checks, rather than an immediate biopsy.

Screening has a downside to weigh. PSA can flag harmless or slow cancers that would never cause trouble, which can lead to biopsies and treatment side effects. Many slow cancers are now watched rather than treated.

What You Can Do to Lower Your Risk

In men with high genetic risk, a healthy lifestyle was linked to about half the rate of deadly prostate cancer.³⁷ Lifetime risk of deadly disease fell from about 5% to under 2% in those men.³⁸ The healthy pattern was a healthy weight, regular exercise and a diet that doesn’t spike insulin.³⁹ Healthy habits didn’t lower the chance of being diagnosed at all, only of the deadly kind.⁴⁰

In daily life, that means brisk activity on most days, such as fast walking, cycling or swimming. Limit sugary drinks, refined carbohydrates and processed meats, which fits a diet that doesn’t spike insulin. Weight in a healthy range often follows from those two habits. Don’t smoke, since smoking is linked to worse outcomes in men who do develop prostate cancer. These habits also help your heart and general health whatever your genes.

Finasteride, a pill used for enlarged prostate, lowered prostate cancer risk by about a quarter, including in men with family history.⁴¹ But slightly more high-grade cancers were found in men taking it, 6.4% vs 5.1%.⁴² Discuss it with your doctor rather than starting it on your own.

Is Familial Prostate Cancer More Dangerous

Men with family history were more often diagnosed with lower-grade cancer, 50% vs 39%.⁴³ Many are screened earlier and caught sooner. That doesn’t make familial cancer harmless: in one study, familial cancers returned more often after surgery,⁴⁴ so follow-up still matters. Cancers linked to BRCA2 are the clear exception and tend to be aggressive,⁴⁵ which is another reason to ask about genetic testing.

Your dad’s cancer grade doesn’t set yours. Your own screening and genes matter more than his outcome. You can ask his doctors whether his tumor was tested for gene changes.

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