San Antonio, Texas USA (UroToday.com) Andrew K. Kader, University of California San Diego, discussed genetic variants in prostate cancer and potential role in screening and prevention. Recent stage migration has resulted in a shift of identifying indolent prostate cancer with concern regarding over diagnosis, over treatment, morbidity and increased costs associated with diagnosis and treatment of prostate cancer.
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Moreover, there is pressing need to better identify patients with clinically significant disease beyond PSA and DRE. Genetic polymorphisms have potential implications in prostate cancer screening. The genome wide association study initially identified 5 potential single nucleotide polymorphisms (SNPs) and since that time several more have been identified including the development of a 33 SNP prostate genetic score (PGS) which outperformed clinical predictors for prostate cancer. The PGS offers a spectrum of risk and potential to identify men at extremely high risk for prostate cancer. Therefore, a possible risk adapted screening algorithm may improve screening efforts and identifying which men are at greatest risk for clinically significant prostate cancer. In regards to chemoprevention, the REDUCE trial found a 23% relative reduction of prostate cancer among men taking dutasteride, however, these men also had a higher incidence of high grade cancer when diagnosed. Using the PGS among men in the REDUCE trial may help risk stratify patients and further validation is needed to confirm the utility of SNPs in chemoprevention.
Presented by: Andrew K. Kader, University of California San Diego
Written By: Stephen B. Williams, MD and Ashish M. Kamat
17th Annual Meeting of the Society of Urologic Oncology - November 30 -December 2, 2016 – San Antonio, Texas USA