Prostate cancer: Risk increases with the
number of affected family members
For a long time now doctors have known that
prostate cancer "runs in the family".
Men with family members who have been
diagnosed with the disease have an elevated
risk of developing cancer of the prostate.
But exactly how high is an individual
person's risk? For whom and at what age
should an early detection screening urgently
be recommended?
Researchers of the department headed by Kari
Hemminki at DKFZ have analyzed these
questions in the largest study ever
published on familial prostate cancer. The
study included 26,651 prostate cancer
patients, 5,623 of whom came from families
in which the disease had been diagnosed
before.
The more of a man's direct relatives, i.e.
brothers and fathers, are affected, the
higher is his personal risk to develop
prostate cancer himself.
Thus, the researchers calculated that men up
to an age of 65 years with three affected
brothers have a risk that is 23 times higher
than that of the control group (men without
affected family members).
Men aged between 65 and 74 years, whose
father was or is the only one affected, have
a risk that is increased by 1.8 times and,
thus, the lowest risk elevation in the
familial cancer group. The DKFZ researchers
recognized a general tendency that the
personal risk is the higher, the younger
affected relatives were at the time of
diagnosis.
Elevated familial cancer risks are often
doubted. Critics argue that results tend to
be distorted because relatives of affected
persons are alarmed and have early detection
exams more often than the rest of the
population.
For this reason, the argument runs, they are
more frequently overdiagnosed, because even
tumors are found that might never have
caused any symptoms during their lifetime.
In order to refute this criticism, the DKFZ
researchers also investigated the prostate
cancer mortality in relation to the number
of affected family members.
They arrived at the same risk distribution
as for newly diagnosed cases: The more
direct relatives are affected, the higher is
a person's risk of dying from prostate
cancer.
Thus, the scientists have proved that the
risk increase is real and not just due to
more frequent early detection examinations.
"Our results provide a good guidance for
doctors. If a man has several affected
relatives who may even have been diagnosed
at a young age, then his personal risk is
substantially increased.
In this case, a family doctor should
urgently recommend having an early detection
examination," said study head Kari Hemminki.
The study is based on data of the Swedish
National Family Cancer Database which
contains data on 11.8 million individuals
and every single one of over one million
cancer cases that occurred between the years
of 1958 and 2006.
Since
the cancer database is linked with a
multiple-generation register, it is possible
to track cancer cases among parents and
siblings of patients.
###
Andreas Brandt, Justo Lorenzo Bermejo, Jan
Sundquist and Kari Hemminki: Age-Specific
Risk of Incident Prostate Cancer and Risk of
Death from Prostate Cancer Defined by the
Number of Affected Family Members.European
Urology 2010,
DOI: 10.1016/j.eururo.2010.02.002
The German Cancer Research Center (Deutsches
Krebsforschungszentrum, DKFZ) is the largest
biomedical research institute in Germany and
is a member of the Helmholtz Association of
National Research Centers. More than 2,000
staff members, including 850 scientists, are
investigating the mechanisms of cancer and
are working to identify cancer risk factors.
They provide the foundations for developing
novel approaches in the prevention,
diagnosis, and treatment of cancer. In
addition, the staff of the Cancer
Information Service (KID) offers information
about the widespread disease of cancer for
patients, their families, and the general
public.
The Center is funded by the German Federal
Ministry of Education and Research (90%) and
the State of Baden-Württemberg (10%).
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