Family History and the Risk of Prostate Cancer
Prostate cancer is the most common malignancy in American men and the
second most common cause of cancer deaths. Because prostate cancer
produces no symptoms until it is far advanced, at least 40% of men
have metastatic disease--disease that has spread--at the time the tumor
is detected. Recognizing the high incidence and mortality of this
disease, early detection of prostate cancer is of vital importance.
Most women in the United States are aware of the close association
between a family history of breast cancer and their risk of developing
the disease and recognize that if their mother or sister has the
disease they are twice as likely to be affected. Up to this point,
however, important information such as this has not been available
for men with prostate cancer.
Thanks to the participation of many of you, we have just completed
a study comparing the family history of prostate cancer in 690 men
with prostate cancer and 640 spouses who were used as controls.
Fifteen percent of the men with prostate cancer had a brother or
father affected with the disease as opposed to only 8% of the spouses.
Men with father or brother affected with the disease were twice as
likely to develop prostate cancer as men with no affected relatives.
In addition, with increasing numbers of affected family members the
risk increased, e.g. men with 2 or 3 first degree affected relatives
had a five- and 11-fold increased risk of developing prostate cancer
Recognizing that 9-10% of men in the United States will develop
prostate cancer in their lifetime, men with a family history of
prostate cancer should be advised of their significantly increased
prostate cancer risk and after age 40 should undergo yearly digital
rectal examinations. In the future, other screening measures may
prove useful, e.g. serial prostate specific antigen (PSA)
determinations, transrectal ultrasound, or magnetic resonance imaging
of the prostate. This is important information for your brothers and
sons. We are actively searching for genetic probes that may help us
identify individuals at the greatest risk for developing the disease.
TABLE 1. INFLUENCE OF AGE AND CLINICAL STAGE ON POSTOPERATIVE POTENCY
||Number of Affected Relatives
|Father and/or Brothers
|Three or more
|Father/brother or grandfather/uncle
|Three or more