Risk of prostate cancer in relatives of prostate cancer patients in Sweden: A nationwide cohort study

Pattern, Clinical Characteristics, and Impact of Family History on Prostate-Specific Antigen in Prostate Cancer: A Multicenter Study

Prostate cancer (PCa) is a major cause of illness and death in men of Sub-Sahara African origin. The study assessed the pattern of PCa, the effect of family history on PSA at diagnosis, and clinical characteristics of PCa in Nigeria. A cross-sectional survey of 200 participants was performed within a 12-month period in Nigeria. Data were collected through patients' interview and hospital records and analyzed using SPSS version 25. Descriptive and inferential statistics were performed. P values <.05 were significant. Mean age of 68.5 years was observed among the 200 study participants. Only 64 (32.0%) had a positive immediate family history of PCa, and 61 (30.5%) were not aware of their family cancer history. Most patients 140 (70.0%) had lower urinary tract symptom (LUTS)/lower back pain/leg pain, and the average Gleason score was 7.55 (±0.876). Symptoms of LUTS/lower back pain mostly occurred in patients between 58 and 79 years, while LUTS/leg pain was more common in persons between 60 and 84. Average PSA differed among participants; persons with no family cancer history (M = 143.989; 95% confidence interval [CI] = 114.849-173.129), family history of PCa (M = 165.463; 95% CI = 131.435), family history of cervical cancer (M = 133.456; 95% CI = 49.335-217.576), and persons with no knowledge of their family cancer history (M = 121.546; 95% CI = 89.234-153.857). Univariate one-way (F-Tests) showed that family history of cancer had no significant impact on patients' PSA (R2 = 0.017; adjusted R2 = 0.002; df = 3; F = 1.154; p = .329) at diagnosis. PCa mostly occurred in men within 60 to 70 years of age, and family history of cancer did not predict PSA at diagnosis. Patients presented to health facilities at advanced or metastatic stages. These findings highlight the need for policies and strategies that encourage early PCa screening.

The role of genetic testing in prostate cancer screening, diagnosis, and treatment

PURPOSE OF REVIEW

This review provides an overview of the current role of genetic testing in prostate cancer screening, diagnosis, and treatment.

RECENT FINDINGS

Recent studies have uncovered few but highly penetrant rare pathogenic mutations (RPMs), in genes, such as BRCA2, with strong prostate cancer risk and outcomes associations. Over 260 single nucleotide polymorphisms (SNPs) have also been identified, each associated with small incremental prostate cancer risk and when combined in a polygenic risk score (PRS), they provide strong prostate cancer risk prediction but do not seem to predict outcomes. Tumor tissue sequencing can also help identify actionable somatic mutations in many patients with advanced prostate cancer and inform on their risk of harboring a germline pathogenic mutation.

SUMMARY

RPM testing, PRS testing, and tumor sequencing all have current and/or potential future roles in personalized prostate cancer care.