Calculating Prostate Cancer Risk -- MEDICA - World Forum for Medicine

Calculating Prostate Cancer Risk

Photo: Silhouette of a young man

The younger the affected
relatives, the higher the risk
for the patient; © SXC

For a long time now doctors have known that prostate cancer "runs in the family". Men with family members who have been diagnosed with the disease have an elevated risk of developing cancer of the prostate. But how high is an individual person's risk? For whom and at what age should an early detection screening be recommended?

Researchers have analyzed these questions. The study included 26,651 prostate cancer patients, 5,623 of whom came from families in which the disease had been diagnosed before. The researchers calculated that men up to an age of 65 years with three affected brothers have a risk that is 23 times higher than that of the control group (men without affected family members). Men aged between 65 and 74 years, whose father was or is the only one affected, have a risk that is increased by 1.8 times and, thus, the lowest risk elevation in the familial cancer group. The researchers recognized a general tendency: The personal risk is the higher the younger affected relatives were at the time of diagnosis.

Elevated familial cancer risks are often doubted. Critics argue that results tend to be distorted because relatives of affected persons are alarmed and have early detection exams more often than the rest of the population. For this reason, the argument runs, they are more frequently over diagnosed, because even tumours are found that might never have caused any symptoms during their lifetime. In order to refute this criticism, the researchers also investigated the prostate cancer mortality in relation to the number of affected family members. They arrived at the same risk distribution as for newly diagnosed cases: The more direct relatives are affected, the higher is a person's risk of dying from prostate cancer. Thus, the scientists have proved that the risk increase is real and not just due to more frequent early detection examinations.

"Our results provide guidance for doctors. If a man has several affected relatives who may even have been diagnosed at a young age, then his personal risk is substantially increased. A family doctor should urgently recommend having an early detection examination," said study head Kari Hemminki.; Source: Helmholtz Association of German Research Centres