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Morris KE, Kotamarti S, Polascik TJ, Moul JW. Re-thinking How We Use Prostate Health Index for African American Men. Urology 2023:S0090-4295(23)00176-0. [PMID: 36828263 DOI: 10.1016/j.urology.2022.12.057] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 11/02/2022] [Accepted: 12/05/2022] [Indexed: 02/24/2023]
Abstract
OBJECTIVE To assess how the validated Prostate Health Index (PHI) risk stratifications perform with African American (AA) men and establish a threshold PHI value to potentially rule out the need for prostate biopsy. MATERIALS AND METHODS AA men meeting FDA-specified indications for PHI testing (>50 years old, PSA 4-10 and negative DRE) who underwent subsequent biopsy were included. Rates of clinically significant prostate cancer (csPCa, as defined by Gleason score ≥7) across accepted PHI stratifications were recorded. Receiver operator curve (ROC) analysis was undertaken to assess PHI performance to predict csPCa. A phi cutoff providing 90% sensitivity was identified. Among AA men with PSA 4-10 ng/mL, the proportion of men who proceeded to biopsy upon physician recommendation was determined. RESULTS Two hundred nine patients met primary criteria; 91 (43.5%) of which had csPCA. The area under the curve for PHI predicting csPCa was 0.68 (95% CI: 0.61-0.75). Using a phi threshold of <23.0 to avoid biopsy provided 98.9% sensitivity, 9.3% specificity, and would have avoided 4.7% of biopsies. The proportion of those who proceeded to biopsy upon physician recommendation was 81.8%. CONCLUSIONS PHI demonstrated limited performance in our cohort, with current stratifications featuring misleadingly low cancer detection rates for these men. Furthermore, PHI had limited use to avoid prostate biopsy, as the proposed threshold of 23.0 only allowed 4.7% of men to avoid biopsy. Further work is needed to assess and optimize PHI usage in AA men; nonetheless, it may still have use in increasing compliance with biopsy recommendation.
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Affiliation(s)
| | - Srinath Kotamarti
- Division of Urology, Department of Surgery, Duke Cancer Institute, Durham, NC
| | - Thomas J Polascik
- Division of Urology, Department of Surgery, Duke Cancer Institute, Durham, NC
| | - Judd W Moul
- Division of Urology, Department of Surgery, Duke Cancer Institute, Durham, NC.
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Ren ZJ, Cao DH, Zhang Q, Ren PW, Liu LR, Wei Q, Wei WR, Dong Q. First-degree family history of breast cancer is associated with prostate cancer risk: a systematic review and meta-analysis. BMC Cancer 2019; 19:871. [PMID: 31477094 PMCID: PMC6720429 DOI: 10.1186/s12885-019-6055-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 08/19/2019] [Indexed: 02/05/2023] Open
Abstract
Background The relationship between first-degree family history of female breast cancer and prostate cancer risk in the general population remains unclear. We performed a meta-analysis to determine the association between first-degree family history of female breast cancer and prostate cancer risk. Methods Databases, including MEDLINE, Embase, and Web of Science, were searched for all associated studies that evaluated associations between first-degree family history of female breast cancer and prostate cancer risk up to December 31, 2018. Information on study characteristics and outcomes were extracted based on the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement and Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. The quality of evidence was assessed using the GRADE approach. Results Eighteen studies involving 17,004,892 individuals were included in the meta-analysis. Compared with no family history of female breast cancer, history of female breast cancer in first-degree relatives was associated with an increased risk of prostate cancer [relative risk (RR) 1.18, 95% confidence interval (CI) 1.12–1.25] with moderate-quality evidence. A history of breast cancer in mothers only (RR 1.19, 95% CI 1.10–1.28) and sisters only (RR 1.71, 95% CI 1.43–2.04) was associated with increased prostate cancer risk with moderate-quality evidence. However, a family history of breast cancer in daughters only was not associated with prostate cancer incidence (RR 1.74, 95% CI 0.74–4.12) with moderate-quality evidence. A family history of female breast cancer in first-degree relatives was associated with an 18% increased risk of lethal prostate cancer (95% CI 1.04–1.34) with low-quality evidence. Conclusions This review demonstrates that men with a family history of female breast cancer in first-degree relatives had an increased risk of prostate cancer, including risk of lethal prostate cancer. These findings may guide screening, earlier detection, and treatment of men with a family history of female breast cancer in first-degree relatives.
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Affiliation(s)
- Zheng-Ju Ren
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 37, Guo Xue Road, Chengdu, 610041, China
| | - De-Hong Cao
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 37, Guo Xue Road, Chengdu, 610041, China.,State Key Laboratory of Biotherapy and Cancer Center, Collaborative Innovation Center for Biotherapy, West China Hospital, Sichuan University, Chengdu, China
| | - Qin Zhang
- Department of Radiology, Chongqing Traditional Chinese Medicine Hospital, Chongqing, China
| | - Peng-Wei Ren
- Department of Evidence-Based Medicine and Clinical Epidemiology, West China Hospital, Sichuan University, Chengdu, China
| | - Liang-Ren Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 37, Guo Xue Road, Chengdu, 610041, China
| | - Qiang Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 37, Guo Xue Road, Chengdu, 610041, China
| | - Wu-Ran Wei
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 37, Guo Xue Road, Chengdu, 610041, China
| | - Qiang Dong
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, 37, Guo Xue Road, Chengdu, 610041, China.
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Morrison BF, Gordon Y. Does a family history of prostate cancer affect screening behavior in Jamaican men? Rev Panam Salud Publica 2019; 42:e143. [PMID: 31093171 PMCID: PMC6385629 DOI: 10.26633/rpsp.2018.143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Accepted: 06/09/2018] [Indexed: 11/24/2022] Open
Abstract
Objective To determine 1) the characteristics of males with a family history of prostate cancer who presented for screening and 2) the association between family history and diagnosis of prostate cancer in a cohort of screened Jamaican men. Methods The study consisted of a prospective cohort of black men who screened at the Jamaica Cancer Society in Kingston between 2006 and 2016. Data were collected on: 1) age at screening and age at diagnosis of prostate cancer, 2) family history of prostate cancer, and 3) prostate-specific antigen (PSA) and digital rectal examination (DRE) findings. Results Approximately 600 (21.4%) of screened men who reported data on family history (2 791 / 2 867) said they had a family history of prostate cancer. Men with a family history of prostate cancer 1) commenced screening at a younger age than men without a family history (P <0.001) and 2) tended to have a younger age at diagnosis of prostate cancer (P = 0.262). There was no significantly increased risk of prostate cancer in men with a reported family history of prostate cancer (odds ratio: 1.4; 95% confidence interval: 0.821–2.386; P = 0.217). Conclusions Men with a family history of prostate cancer presented frequently for screening and earlier than those without. There was a lack of association between family history of prostate cancer and diagnosis. Further studies are needed to investigate this association and validate family histories.
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Affiliation(s)
- Belinda F Morrison
- Department of Surgery, University of the West Indies-Mona, Kingston, Jamaica
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Jones GW, Kellini O, Roberts R, Girgis N, Brown C, Nottage K, McGowan T, Quee-Brown CS, Brown C. Outcomes of treatment in men with prostate cancer at the cancer centre Bahamas. Cancer Causes Control 2017; 28:1285-1293. [PMID: 28864839 DOI: 10.1007/s10552-017-0940-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 08/05/2017] [Indexed: 11/30/2022]
Abstract
PURPOSE This is a first report from The Bahamas of management and long-term outcomes in men with non-metastatic prostate cancer treated with radiotherapy, with or without androgen deprivation therapy, from 2004 to 2016. METHODS Patients were characterized by baseline factors, stratified by risk groups using tumor stage (clinical T-stage), prostate-specific antigen (PSA) test result and Gleason grade, and sorted by treatment combinations (by radiation volume and use of androgen deprivation). RESULTS Overall, 205/216 men were Afro-Caribbean. Median age was 66. There were 18 low-, 77 intermediate-, and 121 high-risk patients, treated with prostate-only versus pelvis plus prostate radiotherapy, many receiving 2 years of androgen suppression. Time to commence radiation was about 6 months from initial diagnosis. In those not relapsing, global PSA nadir was reached in 4 years and was under 1.0, reduced from a mean at baseline of 31. At 10 years, disease-free experience (32 relapses) was 68% and overall survival was 87%, although only 2/12 deaths were related to prostate cancer. This experience compares favorably with recently published outcomes from other countries using very similar treatments. CONCLUSIONS This study establishes benchmark statistics from diagnosis to long-term follow-up. Outcomes in Bahamian men are consistent with expectations from risk-stratified guidelines followed in developed countries.
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Affiliation(s)
- Glenn Wayne Jones
- The Partners Clinical Research Centre, 72 Collins Avenue, Nassau, Bahamas. .,School of Clinical Medicine and Research, University of West Indies, Nassau, Bahamas. .,The Cancer Centre Eastern Caribbean, Queen Elizabeth Highway, Saint John's, Antigua and Barbuda.
| | - Osama Kellini
- The Cancer Centre Bahamas, 72 Collins Avenue, Nassau, Bahamas
| | - Robin Roberts
- School of Clinical Medicine and Research, University of West Indies, Nassau, Bahamas
| | - Nevein Girgis
- The Cancer Centre Bahamas, 72 Collins Avenue, Nassau, Bahamas
| | - Chelsea Brown
- School of Clinical Medicine and Research, University of West Indies, Nassau, Bahamas
| | - Krista Nottage
- School of Clinical Medicine and Research, University of West Indies, Nassau, Bahamas
| | - Thomas McGowan
- World Health Innovation Network, University of Windsor, Windsor, Canada
| | - Corrine Sin Quee-Brown
- The Partners Clinical Research Centre, 72 Collins Avenue, Nassau, Bahamas.,School of Clinical Medicine and Research, University of West Indies, Nassau, Bahamas
| | - Conville Brown
- The Partners Clinical Research Centre, 72 Collins Avenue, Nassau, Bahamas.,The Cancer Centre Eastern Caribbean, Queen Elizabeth Highway, Saint John's, Antigua and Barbuda.,The Cancer Centre Bahamas, 72 Collins Avenue, Nassau, Bahamas
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Jurado-Penagos A, Garcia-Perdomo HA. Efectividad de los micronutrientes en la prevención del cáncer de próstata. REVISTA DE LA FACULTAD DE MEDICINA 2015. [DOI: 10.15446/revfacmed.v62n3sup.44209] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Abstract
Although family history of prostate cancer (PC) is an established risk factor for the disease, few studies have investigated this relationship among men with an African heritage. The Prostate Cancer in a Black Population (PCBP) study is a large, nationwide case-control study conducted in Barbados, West Indies from 2002 to 2011. In the PCBP study, a family history of PC in fathers or brothers was associated with a threefold increased risk of disease (OR = 3.04, 95 % CI (2.18, 4.22)) and a strong positive relationship was noted for the number of affected first degree relatives. Tumor grade did not generally influence the relationship between family history and PC. The magnitude of risks associated with having a father affected with the disease was slightly higher in the PCBP study compared to other populations. It remains unclear whether this finding is the result of an increased genetic susceptibility in African-Barbadian men.
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Affiliation(s)
- Barbara Nemesure
- Department of Preventive Medicine, Stony Brook Medicine, Stony Brook, NY, 11794-8036, USA,
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Kiciński M, Vangronsveld J, Nawrot TS. An epidemiological reappraisal of the familial aggregation of prostate cancer: a meta-analysis. PLoS One 2011; 6:e27130. [PMID: 22073129 PMCID: PMC3205054 DOI: 10.1371/journal.pone.0027130] [Citation(s) in RCA: 102] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2011] [Accepted: 10/11/2011] [Indexed: 11/19/2022] Open
Abstract
Studies on familial aggregation of cancer may suggest an overall contribution of inherited genes or a shared environment in the development of malignant disease. We performed a meta-analysis on familial clustering of prostate cancer. Out of 74 studies reporting data on familial aggregation of prostate cancer in unselected populations retrieved by a Pubmed search and browsing references, 33 independent studies meeting the inclusion criteria were used in the analysis performed with the random effects model. The pooled rate ratio (RR) for first-degree family history, i.e. affected father or brother, is 2.48 (95% confidence interval: 2.25-2.74). The incidence rate for men who have a brother who got prostate cancer increases 3.14 times (CI:2.37-4.15), and for those with affected father 2.35 times (CI:2.02-2.72). The pooled estimate of RR for two or more affected first-degree family members relative to no history in father and in brother is 4.39 (CI:2.61-7.39). First-degree family history appears to increase the incidence rate of prostate cancer more in men under 65 (RR:2.87, CI:2.21-3.74), than in men aged 65 and older (RR:1.92, CI:1.49-2.47), p for interaction = 0.002. The attributable fraction among those having an affected first-degree relative equals to 59.7% (CI:55.6-63.5%) for men at all ages, 65.2% (CI:57.7-71.4%) for men younger than 65 and 47.9% (CI:37.1-56.8%) for men aged 65 or older. For those with a family history in 2 or more first-degree family members 77.2% (CI:65.4-85.0%) of prostate cancer incidence can be attributed to the familial clustering. Our combined estimates show strong familial clustering and a significant effect-modification by age meaning that familial aggregation was associated with earlier disease onset (before age 65).
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Affiliation(s)
- Michał Kiciński
- Centre for Environmental Sciences, Hasselt University, Diepenbeek, Belgium.
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8
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Gonzalez JR, Consedine NS, McKiernan JM, Spencer BA. Barriers to the Initiation and Maintenance of Prostate Specific Antigen Screening in Black American and Afro-Caribbean Men. J Urol 2008; 180:2403-8; discussion 2408. [DOI: 10.1016/j.juro.2008.08.031] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Indexed: 11/28/2022]
Affiliation(s)
| | | | | | - Benjamin A. Spencer
- Department of Urology, Columbia University, New York, New York
- Department of Epidemiology, Columbia University, New York, New York
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Lalor GC. Review of cadmium transfers from soil to humans and its health effects and Jamaican environment. THE SCIENCE OF THE TOTAL ENVIRONMENT 2008; 400:162-172. [PMID: 18752835 DOI: 10.1016/j.scitotenv.2008.07.011] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/19/2008] [Revised: 07/08/2008] [Accepted: 07/08/2008] [Indexed: 05/26/2023]
Abstract
Concerns about the effects of cadmium on human health have led to numerous guidelines and regulations limiting its concentrations in soils and food and allowable human intakes. These have socio-economic consequences in terms of land use and the marketing of food. The bauxite soils in Jamaica, which are both aluminium ores and agricultural soils contain orders of magnitude higher than world normal concentrations of cadmium resulting in elevated Cd concentrations in several foodstuffs and significant transfers to humans, which would seem to represent a risk factor for increased mortality and/or morbidity in the local populations. But, as in Shipham and other examples, there is no evidence of cadmium-related human distress. Macro-indicators like life expectancy and median ages of death do not show cadmium related geographical distributions. The present review focuses on the soils and foods and illnesses of high incidence especially cancers and renal disease that have been traditionally associated with cadmium. In view of the remarkable concentrations of cadmium involved in Jamaica, and often contradictory reports in the literature, it appears that much remains to be learned about certain details of cadmium toxicity.
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Affiliation(s)
- Gerald C Lalor
- International Centre for Environmental and Nuclear Sciences, University of the West Indies Mona, Kingston, Jamaica.
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10
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Mahajan R, Bonner MR, Hoppin JA, Alavanja MC. Phorate exposure and incidence of cancer in the agricultural health study. ENVIRONMENTAL HEALTH PERSPECTIVES 2006; 114:1205-9. [PMID: 16882526 PMCID: PMC1551990 DOI: 10.1289/ehp.8911] [Citation(s) in RCA: 71] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
BACKGROUND We recently reported a link between use of the organophosphate pesticide phorate and risk of prostate cancer among applicators with a family history of prostate cancer in the Agricultural Health Study (AHS). OBJECTIVE This finding, together with findings of associations between other organophosphate pesticides and cancer more broadly, prompted us to examine phorate exposure and overall cancer incidence in the AHS. Adding 3 years of follow-up and using more detailed exposure information allowed us to see whether the prostate cancer finding held. METHODS The AHS is a prospective study of licensed restricted-use pesticide applicators from North Carolina and Iowa. To our knowledge, this is the largest examination of workers occupationally exposed to phorate. Pesticide exposure and other information was collected using two self-administered questionnaires completed from 1993 to 1997. Poisson regression was used to calculate rate ratios (RR) and 95% confidence intervals (CI), adjusting for potential confounders. RESULTS Phorate use was not related to the incidence of all cancers combined or to any individual cancer, although we had insufficient numbers to study non-Hodgkin lymphoma or leukemia, which have been linked to organophosphates in other studies. Although prostate cancer risk was not significantly related to phorate use overall or among those without a family history, the risk tended to increase among applicators with a family history of prostate cancer. The interaction RR was 1.53 (95% CI, 0.99-2.37). CONCLUSION The observed statistical interaction suggests a gene-environment interaction between family history and phorate exposure in the incidence of prostate cancer, but other explanations are also possible.
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Affiliation(s)
- Rajeev Mahajan
- Occupational and Environmental Epidemiology Branch, Division of Cancer
Epidemiology and Genetics, National Cancer Institute, National Institutes
of Health, Department of Health and Human Services, Rockville, Maryland, USA
| | - Matthew R. Bonner
- Occupational and Environmental Epidemiology Branch, Division of Cancer
Epidemiology and Genetics, National Cancer Institute, National Institutes
of Health, Department of Health and Human Services, Rockville, Maryland, USA
| | - Jane A. Hoppin
- Epidemiology Branch, National Institute of Environmental Health Sciences, National
Institutes of Health, Department of Health and Human Services, Research
Triangle Park, North Carolina, USA
| | - Michael C.R. Alavanja
- Occupational and Environmental Epidemiology Branch, Division of Cancer
Epidemiology and Genetics, National Cancer Institute, National Institutes
of Health, Department of Health and Human Services, Rockville, Maryland, USA
- Address correspondence to M.C.R. Alavanja, 6120 Executive Blvd., EPS 8000, Occupational
and Environmental Epidemiology Branch, Division of Cancer
Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland 20852 USA. Telephone: (301) 435-4720. Fax: (301) 402-1819. E-mail:
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Kommu S, Edwards S, Eeles R. The clinical genetics of prostate cancer. Hered Cancer Clin Pract 2004; 2:111-21. [PMID: 20233465 PMCID: PMC4392519 DOI: 10.1186/1897-4287-2-3-111] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2004] [Accepted: 07/27/2004] [Indexed: 12/24/2022] Open
Abstract
Prostate cancer is the most common cancer in men and the second highest cause of cancer-related mortality in the U.K. A genetic component in predisposition to prostate cancer has been recognized for decades. One of the strongest epidemiological risk factors for prostate cancer is a positive family history. The hunt for the genes that predispose to prostate cancer in families has been the focus of many research groups worldwide for the past 10 years. Both epidemiological and twin studies support a role for genetic predisposition to prostate cancer. Familial cancer loci have been found, but the genes that cause familial prostate cancer remain largely elusive. Unravelling the genetics of prostate cancer is challenging and is likely to involve the analysis of numerous predisposition genes. Current evidence supports the hypothesis that excess familial risk of prostate cancer could be due to the inheritance of multiple moderate-risk genetic variants. Although research on hereditary prostate cancer has improved our knowledge of the genetic aetiology of the disease, a lot of questions still remain unanswered. This article explores the current evidence that there is a genetic component to the aetiology of prostate cancer and attempts to put into context the diverse findings that have been shown to be possibly associated with the development of hereditary prostate cancer. Linkage searches over the last decade are summarised. It explores issues as to why understanding the genetics of prostate cancer has been so difficult and why despite this, it is still a major focus of research. Finally, current and future management strategies of men with Hereditary Prostate Cancer (HPC) are discussed.
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Affiliation(s)
- Sashi Kommu
- Reader in Clinical Cancer Genetics, Translational Cancer Genetics Team, Institute of Cancer Research, Sutton, UK.
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Bostwick DG, Burke HB, Djakiew D, Euling S, Ho SM, Landolph J, Morrison H, Sonawane B, Shifflett T, Waters DJ, Timms B. Human prostate cancer risk factors. Cancer 2004; 101:2371-490. [PMID: 15495199 DOI: 10.1002/cncr.20408] [Citation(s) in RCA: 395] [Impact Index Per Article: 19.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Prostate cancer has the highest prevalence of any nonskin cancer in the human body, with similar likelihood of neoplastic foci found within the prostates of men around the world regardless of diet, occupation, lifestyle, or other factors. Essentially all men with circulating androgens will develop microscopic prostate cancer if they live long enough. This review is a contemporary and comprehensive, literature-based analysis of the putative risk factors for human prostate cancer, and the results were presented at a multidisciplinary consensus conference held in Crystal City, Virginia, in the fall of 2002. The objectives were to evaluate known environmental factors and mechanisms of prostatic carcinogenesis and to identify existing data gaps and future research needs. The review is divided into four sections, including 1) epidemiology (endogenous factors [family history, hormones, race, aging and oxidative stress] and exogenous factors [diet, environmental agents, occupation and other factors, including lifestyle factors]); 2) animal and cell culture models for prediction of human risk (rodent models, transgenic models, mouse reconstitution models, severe combined immunodeficiency syndrome mouse models, canine models, xenograft models, and cell culture models); 3) biomarkers in prostate cancer, most of which have been tested only as predictive factors for patient outcome after treatment rather than as risk factors; and 4) genotoxic and nongenotoxic mechanisms of carcinogenesis. The authors conclude that most of the data regarding risk relies, of necessity, on epidemiologic studies, but animal and cell culture models offer promise in confirming some important findings. The current understanding of biomarkers of disease and risk factors is limited. An understanding of the risk factors for prostate cancer has practical importance for public health research and policy, genetic and nutritional education and chemoprevention, and prevention strategies.
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Bruner DW, Moore D, Parlanti A, Dorgan J, Engstrom P. Relative risk of prostate cancer for men with affected relatives: systematic review and meta-analysis. Int J Cancer 2003; 107:797-803. [PMID: 14566830 DOI: 10.1002/ijc.11466] [Citation(s) in RCA: 114] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
An increased risk of prostate cancer associated with a family history of prostate cancer has been documented in multiple published reports. Risk has been shown to vary by degree of relationship and age of onset of disease in the affected relative. Several studies, using various designs, have estimated the relative risk (RR) for these associations. The purpose of our study was to identify and summarize published reports on the relationship between risk of prostate cancer and family history, which is defined as having a father, brother, any first- or second-degree relative or other relative affected with prostate cancer. A Medline and manual search from 1982 to 2000 identified 24 studies that reported RR and confidence intervals (CI) and satisfied inclusion criteria. Pooled RR estimates based upon a weighted average model were as follows: any affected family member RR = 1.93, CI 1.65-2.26; affected first-degree relative RR = 2.22, CI 2.06-2.40; affected second-degree relative RR = 1.88, CI 1.54-2.30; father with prostate cancer RR = 2.12, CI 1.82-2.51; and brother with prostate cancer RR = 2.87, CI 2.21-3.73). Statistical comparison of pooled data demonstrated that the RR is significantly higher for affected brother than for affected father (p < 0.03). A sensitivity analysis demonstrated that these results are robust with respect to population bias. This meta-analysis confirms that risk of prostate cancer is associated with family history of disease and improves the quantification of this risk.
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Affiliation(s)
- William G Nelson
- Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, USA.
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Abstract
OBJECTIVE To identify published studies quantifying familial prostate cancer risks in relatives of prostate cancer cases and, by meta-analysis, obtain more precise estimates of familial risk according to the family history. METHODS Thirteen case-control and cohort studies were identified which have reported risks of prostate cancer in relatives of prostate cancer cases. Pooled estimates of risk for various categories of family history were obtained by calculating the weighted average of the log relative risk (RR) estimates from studies. RESULTS The pooled RR (95% confidence interval) in first-degree relatives was 2.5 (2.2-2.8). There was evidence that this was highest in relatives of cases diagnosed before age 60 years and that RRs declined with age. The risk for the few men with two affected relatives was increased 3.5-fold (2.6-4.8). RRs to sons of cases appeared to be lower than in brothers; a complete explanation of this observation is uncertain. CONCLUSION Men with a family history of prostate cancer have a significantly greater risk of developing prostate cancer than those with no such history. Risks are greatest for relatives of cases diagnosed when young and those with more than one relative affected.
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Affiliation(s)
- L E Johns
- Section of Cancer Genetics, Institute of Cancer Research, Sutton, Surrey, UK
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16
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Abstract
Major risk factors for developing prostate cancer, including positive family history and African-American ethnicity, can be quantified for genetic counseling. Factors increasing familial risk for prostate cancer are closer degree of kinship, number of affected relatives, and early age of onset (< 50 years) among the affected relatives. Genetic testing may be useful for modification of risk, but currently should be performed only within the context of a well-designed research study that will determine penetrance and genotype-phenotype correlation of specific mutations. Even in the absence of genetic testing, African-American men and men with a strong family history of prostate cancer may opt to initiate screening by prostate specific antigen (PSA) and digital rectal exam (DRE) screening at age 40.
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Affiliation(s)
- A M Nieder
- Department of Urology and NYU Cancer Institute, New York University School of Medicine, 550 First Avenue, New York, NY 10016, USA
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18
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Ostrander EA, Stanford JL. Genetics of prostate cancer: too many loci, too few genes. Am J Hum Genet 2000; 67:1367-75. [PMID: 11067781 PMCID: PMC1287913 DOI: 10.1086/316916] [Citation(s) in RCA: 143] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2000] [Accepted: 10/12/2000] [Indexed: 11/04/2022] Open
Affiliation(s)
- E A Ostrander
- Division of Human Biology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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Abstract
Rapid advances in positional cloning studies have identified most of the genes on the human Y chromosome, thereby providing resources for studying the expression of its genes in prostate cancer. Using a semiquantitative reverse transcription-polymerase chain reaction (RT-PCR) procedure, we had examined the expression of the Y chromosome genes in a panel of prostate samples diagnosed with benign prostatic hyperplasia (BPH), low and/or high grade carcinoma, and the prostatic cell line, LNCaP, stimulated by androgen treatment. Results from this expression analysis of 31 of the 33 genes, isolated so far from the Y chromosome, revealed three types of expression patterns: i) specific expression in other tissues (e.g., AMELY, BPY1, BPY2, CDY, and RBM); ii) ubiquitous expression among prostate and control testis samples, similar to those of house-keeping genes (e.g., ANT3, XE7,ASMTL, IL3RA, SYBL1, TRAMP, MIC2, DBY, RPS4Y, and SMCY); iii) differential expression in prostate and testis samples. The last group includes X-Y homologous (e.g., ZFY, PRKY, DFFRY, TB4Y, EIF1AY, and UTY) and Y-specific genes (e.g., SRY, TSPY, PRY, and XKRY). Androgen stimulation of the LNCaP cells resulted in up-regulation of PGPL, CSFR2A, IL3RA, TSPY, and IL9R and down regulation of SRY, ZFY, and DFFRY. The heterogeneous and differential expression patterns of the Y chromosome genes raise the possibility that some of these genes are either involved in or are affected by the oncogenic processes of the prostate. The up- and down-regulation of several Y chromosome genes by androgen suggest that they may play a role(s) in the hormonally stimulated proliferation of the responsive LNCaP cells.
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Affiliation(s)
- Y F Lau
- Division of Cell and Developmental Genetics, Department of Medicine, VA Medical Center, 111C5, University of California, San Francisco, San Francisco, California 94121, USA.
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Affiliation(s)
- O Bratt
- Department of Surgery, Helsingborg Hospital, Helsingborg, Sweden.
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