Prostate cancer risk in men with prostate and breast cancer family history: Results from the REDUCE study (R1) - Abstract

Background: To what degree the associations between PCa risk and family history of prostate cancer (PCa) and/or breast cancer (BCa) are attributable to screening biases is unclear. We examined these questions within the REDUCE study, where biopsies were largely independent of prostate specific antigen (PSA) minimizing screening biases.

Methods: Data were from REDUCE, which tested dutasteride 0.5 mg daily for PCa risk reduction in men with PSA 2.5-10.0 ng mL-1 and a negative prestudy biopsy. Among men undergoing at least one on-study biopsy with complete data (n = 6415; 78.1%), the association between family history and PCa risk was tested using multivariate logistic regression adjusting for clinicodemographic characteristics.

Results: A family history of PCa alone was associated with increased PCa diagnosis (OR: 1.47, 95%CI: 1.22-1.77). In North America, PCa family history was not related to PCa diagnosis (OR: 1.02, 95%CI: 0.73-1.44), whereas outside North America, PCa family history was significantly related to diagnosis (OR: 1.72, 95%CI: 1.38-2.15) (P-interaction = 0.01). A family history of both PCa and BCa (OR: 2.54, 95%CI: 1.72-3.75) but not BCa alone (OR: 1.04, 95%CI: 0.84-1.29) was associated with increased PCa risk versus no family history and irrespective of geographical region.

Conclusions: In REDUCE, PCa family history was significantly related to PCa diagnosis, although only for men outside North America. The presence of both PCa and BCa family history significantly increased risk versus PCa family history alone, irrespective of geographical region. Ultimately, our observations may support the need for changes in how we address family history in terms of both risk of PCa diagnosis and general risk stratification.

Written by:
Thomas JA 2nd, Gerber L, Moreira DM, Hamilton RJ, Bañez LL, Castro-Santamaria R, Andriole GL, Isaacs WB, Xu J, Freedland SJ.   Are you the author?
Surgery Section, Durham VA Medical Center, Durham, NC; Duke Prostate Center, Division of Urological Surgery, Department of Surgery, Duke University School of Medicine, Durham, NC; The Author Smith Institute for Urology, New Hyde Park, NY Memorial Sloan-Kettering Cancer Center, New York, NY; GlaxoSmithKline, Research Triangle Park, NC Washington University School of Medicine in St. Louis, St. Louis, MO; Department of Urology, Johns Hopkins Hospital, Baltimore, MD; Center for Genomics and Personalized Medicine Research, Wake Forest University, Winston-Salem, NC; Department of Pathology, Duke University School of Medicine, Durham, NC, USA.

Reference: J Intern Med. 2011 Dec 28. Epub ahead of print.
doi: 10.1111/j.1365-2796.2011.02504.x

PubMed Abstract
PMID: 22211699 Prostate Cancer Section