Men with Both Prostate and Other Cancers May Be Slipping Through Genetic Screening Crack, Study Finds

Men with Both Prostate and Other Cancers May Be Slipping Through Genetic Screening Crack, Study Finds

Men with both prostate and other cancers may be falling through a genetic screening crack that could have flagged the additional cancers, a study reports.

Most prostate cancer patients with mutations that predispose them to cancer do not meet guidelines for family-history genetic screening, researchers said.

The study, “Germline genetic variants in men with prostate cancer and one or more additional cancers,” was published in the journal Cancer.

“We commonly use a combination of a patient’s personal and family cancer histories to identify those individuals who may have a mutation in a gene that predisposes that individual to developing cancers,” Dr. Patrick Pilié, an oncology fellow at the University of Texas MD Anderson Cancer Center, said in a news release. He is the first author of the study.

“Testing for hereditary cancers impacts not only the patient with cancer but also potentially the cancer screening and health outcomes of their entire family,” Pilié said. “But many prostate cancer patients do not meet the current guidelines to test for genetic cancer heritability.”

The study included 102 patients diagnosed with prostate cancer and at least one additional cancer. Advanced next-generation DNA sequencing methods showed that 11 percent of the patients had gene mutations that could contribute to prostate cancer development. Many of the genes were involved in DNA repair pathways.

“These mutations prevent the DNA from healing itself, which can lead to a predisposition for cancer,” said Dr. Kathleen Cooney, chair of internal medicine at the University of Utah.

When they examined the patients’ family history, the team discovered that 64 percent would not meet guidelines that identify who should have genetic screening, based on their personal and family histories.

“Our findings are in line with those of other studies, suggesting that approximately one in 10 men with advanced prostate cancer harbors a genetic variant associated with increased cancer risk,” said Dr. Elena Stoffel of the University of Michigan Comprehensive Cancer Center, who was author of the study. “While family history is an important tool, there may be better ways to identify patients with genetic risk.”

Identifying those with mutations predisposing them to cancer could have an important impact on patients’ treatment and outcomes, the researchers said. Revising genetic screening criteria could lead to  individualized and more effective treatments for these patients, the team said.

“This approach will help us identify patients at greater risk for aggressive prostate cancer so they can seek earlier screening while pre-symptomatic,” Cooney said.

Additional studies in larger groups of patients could help identify characteristics associated with tumors that arise in patients with genetic mutations, the researchers said.