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New findings concerning hereditary prostate cancer

New findings indicate that men whose father or brother have an indolent, untreated prostate cancer increases their own risk of developing aggressive prostate cancer. Photo: Uni. of Michigan
New findings indicate that men whose father or brother have an indolent, untreated prostate cancer increases their own risk of developing aggressive prostate cancer. Photo: Uni. of Michigan

For the first time ever, researchers have differentiated the risks of developing indolent or aggressive prostate cancer in men with a family history of the disease. Researchers from the Swedish universities of Lund, Uppsala and Umeå now present new and somewhat surprising results.

It is a well-known fact that men with a family history of prostate cancer run an increased risk of developing the disease. The risk for brothers of men with prostate cancer is doubled. But a doubled risk of what, exactly? Prostate cancer my be an indolent condition that does not require treatment, or aggressive and fatal. Obviously, it makes a big difference whether a man has an increased risk of developing the indolent or the aggressive form, but until now these different risks have not been known.

The Swedish researchers studied the risk of cancer in over 50,000 brothers of men with prostate cancer. Thirty per cent of the men that had one brother only with prostate cancer were diagnosed with prostate cancer by age 75 years, about double the Swedish national average risk of 13 per cent. Their risk of aggressive prostate cancer was much lower: 9 per cent (national average risk 5 per cent).

In men that had both a father and a brother with prostate cancer, the risk of any form of prostate cancer was as high as 48 per cent; the risk of the aggressive form was 14 per cent.

The researchers also studied how the different risks were affected by the severity of the cancer in an affected brother or father:

“We expected that the risk of aggressive prostate cancer would not be much increased in brothers of men with the indolent form, but it turned out to almost as high as the risk among men with aggressive prostate cancer in the family”, says Associate Professor Ola Bratt at Lund University, who lead the research project. “This is an important finding that needs to be disseminated to the general public and to healthcare professionals. Men whose father or brother have an indolent, untreated prostate cancer are probably not aware that this increases their own risk of developing aggressive prostate cancer. They might not even know that there is prostate cancer in the family”, says Ola Bratt.

The study emanates from the research database PCBaSe. The principal investigator of PCBaSe is Pär Stattin, Professor of Urology at the universities in Uppsala and Umeå.

Publication
Ola Bratt, Linda Drevin, Olof Akre, Hans Garmo & Pär Stattin: “Family History and Probability of Prostate Cancer, Differentiated by Risk Category – a Nationwide Population-Based Study”, published online in the Journal of the National Cancer Institute.

Read online publication at JNCI website

Contact:

Ola Bratt, Associate Professor of Urology, Department of Translational Medicine at Lund University, Sweden, and Urologist at Cambridge University Hospital, England. Telephone: +44 79 82 90 00 43, email: ola [dot] bratt [at] med [dot] lu [dot] se (ola[dot]bratt[at]med[dot]lu[dot]se)

Facts about prostate cancer

Prostate cancer is the second most common cancer in men worldwide. It affects about 20 per cent of Swedish men. Family history is a strong risk factor, but there is no genetic test that can identify men with a hereditary predisposition. The use of the blood test PSA to facilitate early diagnosis of prostate cancer is much debated, as PSA testing leads to overdiagnosis and overtreatment of indolent cancers. Men with a family history of prostate cancer are, however, usually recommended PSA testing from age 40–50 years.

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