“To date, there have been few recommendations to guide physicians about when to offer men genetic consultation for prostate cancer risk. Now, an international and inter-specialty panel of experts convened at the Sidney Kimmel Cancer Center (SKCC) at Thomas Jefferson University have developed a comprehensive set of recommendations. This consensus statement, published December 13th in the Journal of Clinical Oncology, will help physicians and stakeholders make sense of a rapidly evolving field of practice.”
“Inherited mutations in DNA-repair genes, such as the BRCA genes, can increase cancer risk. A new study shows that DNA-repair mutations are significantly more common in men with metastatic prostate cancer compared with men whose prostate cancer hasn’t spread. This suggests all men with advanced prostate cancer should be tested for inherited DNA-repair mutations to help select the most effective therapies and provide information on family risk.”
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“Genetic variants were associated with increased risk for early onset prostate cancer, with patients diagnosed at a younger age exhibiting a greater likelihood of cause-specific mortality than older men, according to a recent meta-analysis.
“ ‘Early onset prostate cancer tends to be aggressive, striking down men in the prime of their life,’ Kathleen A. Cooney, MD, professor of internal medicine and urology at the University of Michigan, said in a press release. ‘These fast-growing tumors in young men might be entirely missed by screening because the timeframe is short before they start to show clinical symptoms.’
“In an analysis of current literature, Cooney and colleagues characterized the differences between early-onset prostate cancer – diagnosed at or before age 55 – and prostate cancer diagnosed at an older age. In particular, researchers noted that the occurrence of early onset prostate cancer had increased from 5.6 cases per 100,000 person years in 1986 to 32 cases per 100,000 person years in 2008 (95% CI 5.0 to 6.7).
“Researchers also cited study results which found that among men diagnosed with stage IV prostate cancer, those aged between 35 and 44 years had a 1.5-fold greater risk of prostate cancer-specific mortality than men aged between 64 and 75 years; prognoses were also found to be worse worse for men over 80.
“Additionally, younger men diagnosed with high-grade tumors were 1.4 times more likely to die of prostate cancer than men diagnosed at an older age.
“According to analysis results, men in the younger age groups were more likely to have a family history of prostate cancer, and were also more likely to exhibit a greater number of genetic variants linked to increased risk of prostate cancer than older men in genome-wide association studies.”
An ongoing collaboration of more than 50 research groups around the world has identified 23 new genes or genomic regions that may contribute to the development of prostate cancer. These findings allow for a more accurate assessment of a person’s risk of developing prostate cancer. The results were published in the April, 2013, issue of Nature Genetics (doi:10.1038/ng.2560).
Including the 23 new prostate cancer susceptibility genetic loci, there are now a total of 77 known loci linked to prostate cancer. This accounts for about 30% of all familial risk for prostate cancer—the other factors for familial risk for prostate cancer are not yet defined. Continue reading…