Prostate cancer risk and first-degree relatives

It would be easy to get the impression that there is nothing new on the prostate cancer front except what’s coming out from San Francisco, but here’s some interesting new information from Germany and Sweden.

Brandt et al. set out to determine the age-specific risks of prostate cancer and the risk of death from prostate cancer for a individuals based on the number and the age of  first-degree relatives (fathers and brothers) who had also been diagnosed with or died from prostate cancer.

The Swedish Family-Cancer Database includes data on more than 11.8 million individuals and their cancers from 1958 to 2006. Brandt et al. examined the information on all men in this database together with their identified parents (more than3.9 million individuals) between 1961 and 2006. They were able to identify a total of 26,651 prostate cancer patients, of whom 5,623 were familially interconnected.

Based on these data, Brandt and colleagues were able to calculate the age-specific hazard ratios (HRs) for a diagnosis of prostate cancer and the HRs for prostate cancer-specific death based on the number and age of affected fathers and brothers. Their results can be summarized as follows:

  • The HRs for a diagnosis of prostate cancer increased with the number of affected relatives and decreased with increasing age.
  • The highest HRs were observed for men < 65 years of age with three affected brothers (HR = ~ 23).
  • The lowest HRs were observed for men between 65 and 74 years of age with only an affected father (HR = ~ 1.8).
  • The HRs increased with decreasing paternal or fraternal diagnostic age.
  • The pattern of the risk of death from familial prostate cancer was similar to the incidence data.

This information is obviously specific to Swedish patients, but it does offer useful information that can help with clinical counseling of patients with a family history of prostate cancer, and it also gives a clear demonstration of the very considerable variations in individual risk for men who have multiple first-degree relatives with prostate cancer.

2 Responses

  1. One of the issues about familial prostate cancer diagnoses that struck me when I first found that there were to be changes in the identification and grading of material from biopsy procedures was that many men diagnosed with prostate cancer in the era from the initiation of PSA testing until now might not be so diagnosed now. This would mean that their relations would be unneccessarily concerned about prostate cancer.

  2. Where in the world does it say that GS 5 is not cancer? The family history of prostate cancer risk is well documented. Men with a family history of prostate cancer should be aware of their increased risk irrelevant of the changes in cancer grading.

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