Challenging the Inevitability of Age Related Prostate Enlargement: Low Levels of Benign Prostatic Hyperplasia among Bolivian Amerindians

Benjamin Trumble, University of California, Santa Barbara
Daniel Eid R., Universidad Mayor San Simon, Bolivia
Edhit Cortez Linares, Proyecto de Salud y Antropologia
Michael D. Gurven, University of California, Santa Barbara

In industrialized populations, prostate enlargement and prostate cancer increases with age, with 90% of men above the age of 80 experiencing benign prostatic hyperplasia (BPH). Many consider prostate enlargement to be inevitable effect of aging, though little is known about prostate health in non-Western subsistence populations. Cumulative testosterone exposure is positively associated with BPH, thus examining Tsimane forager-horticulturalists with significantly lower testosterone levels than US males is of interest. Prostate volume was measured by abdominal ultrasound in 350 Tsimane men aged 28-89. While prostate volume increases with age (p=0.006), volumes were significantly lower among the Tsimane compared to men industrialized populations (p<0.001), with less than half the levels of BPH reported in the US. We challenge the notion that BPH is an inevitable part of male ageing; clinically relevant prostate enlargement would not have been the norm throughout human evolution, and may be a byproduct of industrialized living conditions.