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Familial prostate cancer risk

 

Bottom line

Male relatives of men with prostate cancer are themselves at higher risk of having prostate cancer. The risk is about 2.5 times higher with an affected first degree relative (father, brother, son), and higher still in men with more than one affected first degree relative, having a relative diagnosed with prostate cancer before age 60, or being younger than 65 with an affected first degree relative.

Background

Prostate cancer is one of the most common cancers in men. Having a first degree relative (father, brother, or son) with prostate cancer increases the risk according to age at diagnosis, and the type of relative and number of relatives affected.

Reference

LE Johns, RS Houlston. A systematic review and meta-analysis of familial prostate cancer risk. BJU International 2003 91: 789-794.

 

Systematic review

This systematic review looked for studies published between 1996 and 2002 (August) that examined prostate cancer risk and familial relationships. It pooled data from the studies to provide an overall risk for relatives of men with prostate cancer.

Results

After removing a number of studies that duplicated information, 13 studies remained. The results are shown in Table 1. The overall risk of prostate cancer for a man with a first degree relative with prostate cancer was 2.5. Higher risks were associated with having more than one affected first degree relative, having a relative diagnosed with prostate cancer before age 60, or being younger than 65 with an affected first degree relative.

Table 1: Risk of prostate cancer with affected relatives (relative to no affected male relatives)

Relationship/circumstances
Relative risk
(95% CI)
At least one first degree affected relative
2.5 (2.2 to 2.8)
Father affected
2.5 (2.1 to 3.1)
Brother affected
3.4 (2.9 to 4.1)
Men aged under 65 with first degree relative
4.3 (2.9 to 6.3)
Men aged over 65 with first degree relative
2.4 (2.0 to 2.9)
Relative diagnosed before age 60
4.3 (2.9 to 6.3)
More than one affected first degree relative
4.6 (2.7 to 8.0)

 

Comment

Genes are not modifiable, at least not for us as individuals. When a relative of a man without prostate cancer does have prostate cancer, the risks for the man without prostate cancer are increased, compared with men without an affected relative. This is useful information, especially with the advent of more screening for prostate cancer using PSA tests.