Evolution, civilization, and prostate cancer: A comparative analysis of the impact of diet, longevity, and social behavior in humans and higher primates

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Abstract
The prostate is a specific male organ where the urinary and reproductive pathways anatomically and functionally intersect. This exocrine gland, whose evolutionary roots date back to the first mammals approximately 65 million years ago, plays a crucial role in male fertility: its secretion provides an optimal environment for the survival and motility of spermatozoa. Prostate diseases currently represent one of the greatest medical and healthcare challenges for the modern man. Benign prostatic hyperplasia (BPH) is the fourth most common chronic disease in the male population, while prostate cancer (PCa) is the most frequent malignancy among men in the developed world. The human prostate represents a unique biological paradox. While our closest evolutionary relatives, the great apes and Old-World monkeys, rarely develop malignant tumors of this gland despite a similar anatomy and the occurrence of benign changes in old age, the incidence of prostate cancer (PCa) in humans is dramatically high. This paper hypothesizes that the key to understanding this discrepancy lies in the dietary shift that occurred approximately 15,000 years ago. The radical transition from a primate, antioxidant-rich diet to a high-calorie meat diet, the dramatic extension of human longevity, and the evolution of sexual relationships from a purely reproductive function to a complex social category have created an evolutionary mismatch that has made the human prostate a primary target of modern oncology.

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