New research led by Huntsman Cancer Institute investigators and published in the The Prostate journal, has shown that looking into a man’s more complete family history, uncles and great-parents, can be of crucial value to decide if a PSA test is appropriate for prostate cancer detection.
“Family history is a substantial risk factor for prostate cancer,” Lisa Cannon-Albright, PhD, professor of genetic epidemiology and an HCI investigator said in a news release. “But typically, a clinician will ask a patient whether there are any people in the family with prostate cancer, possibly identifying whether they are first-degree relatives. And that’s about as far as it goes.”
The team of researchers analyzed data from the Utah Population Database, that links genealogic and medical information for over 7.3 million individuals, and created a personalized risk estimative for men by looking into their family prostate cancer history (first-, second-, and third-degree relatives).
The individualized relative risks for men who had a family history of prostate cancer were calculated based on the number, degree, and age at diagnosis of their affected ancestors.
The team then pinpointed combinations of these factors that were associated with a greater than two and three-fold risk of developing prostate cancer.
The results showed that two-thirds of Utah men have an increased risk of prostate cancer due to their family history of the malignancy. However, there are only a small number of men who are considered to be at high risk.
“The clinical application of our findings is especially relevant because there is no consensus on prostate cancer screening,” co-author Robert A. Stephenson, MD, professor of urologic oncology at the U of U and an HCI investigator said in a news release. “Knowing prostate cancer risk estimates associated with a man’s detailed family history can help pinpoint the men who will benefit from targeted screening.”
Furthermore, these results highlighted the fact that even though PSA testing can increase the number of total prostate cancer cases diagnosed, the number of cases associated with family history are the same before and after PSA screening.
Importantly, the authors found that male relatives from the maternal side of the family also have an impact on prostate cancer risk.
“There may be a synergistic effect if a man has both maternal and paternal family history,” Dr. Cannon-Albright added. “We want to investigate this further, along with bringing other factors such as race, socioeconomic status, and previous diagnosis with another type of cancer into the risk calculations. This will broaden the populations to which the risk estimates apply. Even after we find the genetic mutations responsible for some prostate cancers, family history data will be an economically sustainable, viable, powerful, and effective way to accurately estimate prostate cancer risk,” she concluded.