Prostate cancer in relatives increases its own risk

Prostate cancer in relatives increases its own risk

The more first-degree relatives (father, brothers) have or have had prostate cancer and the younger they were at diagnosis, the more likely a man is also affected by it, according to a new study.
It is known that 10-20% of all cases of prostate cancer occur more frequently within families, so in first-and second-degree (familial prostate cancer). About half of this is considered hereditary, if multiple first-degree relatives, or multiple generations are affected in a row. For the other half other factors such similar circumstances may be responsible (see also causes of prostate cancer ).

Men whose brothers and / or fathers are suffering from prostate cancer or were intended to draw attention to the more than two-fold increased risk of developing prostate cancer during their lifetime, the German S3 guideline for physicians to screening, diagnosis and therapy of prostate cancer (see also: New prostate cancer guidelines ). Thereafter, the relative risk of 2.5 to 4.3 is for each first-degree relatives. The risk also increases all the more, the younger, the more closely related and more numerous the affected relatives are or were.

For this purpose, a new study now provides more accurate figures. It should be determined how high the age-appropriate morbidity and mortality risk for prostate cancer, depending on the age and the number of affected first-degree relatives. For this, the authors evaluated from the Swedish Register of familial cancer cases. Among more than 11.8 million entries were found 1961-2006 26 651 prostate cancer cases, of which 5,623 were family. As a characteristic of the risk, calculated from the data of HR (engl. hazard ratio, "increased risk") was used.

The results were partly clear than previously known. The risk of developing prostate cancer, increased with the number of affected relatives, but decreased with increasing age own. The highest risk, patients under 65 years with three affected brothers (HR 23, that risk increases to 23 times compared to patients without affected relatives). The lowest risk, patients in the highest stated age group 65 to 74 years, in which only the father was ill (HR close to 1.8). The risk of disease also rose more so the younger the relatives rather than with them prostate cancer was observed (up to HR 6 in patients under 55 years with an affected brother or father less than 60 years). The risk of dying from prostate cancer, behaved quite similar to the risk of contracting the disease, with values ​​lower and the case numbers were very low.

The higher disease risk could stem from the fact that men whose relatives are affected by prostate cancer, earlier or more frequent visits to screening than men without affected relatives. Then it would be expected that in the first group more tumors were discovered in the early stages than in the second group. Exactly this was not so in the case: The distribution of tumor stages from 2002 resembled in both groups. This and the fact that the prognosis in familial and at randomly occurring prostate cancer are the same, saying that the higher risk of death was simply due to a higher number of patients.
Early detection of prostate cancer using PSA testing can indeed reduce the risk of death, but increases the number of unnecessary prostate biopsies and treatments (see the early detection of prostate cancer ). Therefore it is increasingly important to accurately assess the risk of familial prostate cancer according to the number and age of affected relatives, according to the authors. The results of this study will help men with an increased risk in their decision for or against screening and an early start the same. This applies especially to those in which a relative erstgradiger 65 before the Age is ill, and those with multiple affected relatives.

Conclusion of the authors
The morbidity and mortality risk for prostate cancer is enormously increased in men whose fathers and / or brothers are also suffering from this disease or were. It is therefore advisable to incorporate the results referred to in the consultation for early detection and in case of illness.