Medline ® Abstract for Reference 6
of 'Genetic risk factors for prostate cancer'
Family History and Probability of Prostate Cancer, Differentiated by Risk Category: A Nationwide Population-Based Study.
Bratt O, Drevin L, Akre O, Garmo H, Stattin P
J Natl Cancer Inst. 2016 Oct;108(10)
BACKGROUND: Familial prostate cancer risk estimates are inflated by clinically insignificant low-risk cancer, diagnosed after prostate-specific antigen testing. We provide age-specific probabilities of non-low- and high-risk prostate cancer.
METHODS: Fifty-one thousand, eight hundred ninety-seven brothers of 32 807 men with prostate cancer were identified in Prostate Cancer data Base Sweden (PCBaSe). Nelson-Aalen estimates with 95% confidence intervals (CIs) were calculated for cumulative, family history-stratified probabilities of any, non-low- (any of Gleason score≥7, prostate-specific antigen [PSA]≥10 ng/mL, T3-4, N1, and/or M1) and high-risk prostate cancer (Gleason score≥8 and/or T3-4 and/or PSA≥20 ng/mL and/or N1 and/or M1).
RESULTS: The population probability of any prostate cancer was 4.8% (95% CI = 4.8% to 4.9%) at age 65 years and 12.9% (95% CI = 12.8% to 12.9%) at age 75 years, of non-low-risk prostate cancer 2.8% (95% CI = 2.7% to 2.8%) at age 65 years and 8.9% (95% CI = 8.8% to 8.9%) at age 75 years, and of high-risk prostate cancer 1.4% (95% CI = 1.3% to 1.4%) at age 65 years and 5.2% (95% CI = 5.1% to 5.2%) at age 75 years. For men with one affected brother, probabilities of any prostate cancer were 14.9% (95% CI = 14.1% to 15.8%) at age 65 years and 30.3% (95% CI = 29.3% to 31.3%) at age 75 years, of non-low-risk prostate cancer 7.3% (95% CI = 6.7% to 7.9%) at age 65 years and 18.8% (95% CI = 17.9% to 19.6%) at age 75 years, and of high-risk prostate cancer 3.0% (95% CI = 2.6% to 3.4%) at age 65 years and 8.9% (95% CI = 8.2% to 9.5%) at age 75 years. Probabilities were higher for men with a stronger family history. For example, men with two affected brothers had a 13.6% (95% CI = 9.9% to 17.6 %) probability of high-risk cancer at age 75 years.
CONCLUSIONS: The age-specific probabilities of non-low- and high-risk cancer presented here are more informative than relative risks of any prostate cancer and more suitable to use for counseling men with a family history of prostate cancer.
Department of Translational Medicine Urology, Division of Urological Cancers, Lund University, Sweden (OB);Department of Urology/CamPARI Clinic, Cambridge University Hospitals, Cambridge, UK (OB);Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden (LD, HG);Department of Urology, Karolinska Institute, Stockholm, Sweden (OA);Department of Surgical and Perioperative Sciences, Urology and Andrology, UmeåUniversity, Umeå, Sweden (PS);Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden (PS). email@example.com.