PURPOSE: To assess if prostate cancer (PCa) screening reduces PCa mortality in Caucasian men with a family history (FH) of prostate cancer.
MATERIALS AND METHODS: Data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) screening trial was used to compare screening and usual care arms within the subset of men with and without a FH of PCa. Univariate, multivariate cox regression analysis, and log-rank analysis of Kaplan-Meier curves were used to examine the data for differences in PCa specific survival.
RESULTS: A total of 65,179 Caucasian subjects were included in the PSA screening trial, of which 7314 (11.2%) were diagnosed with PCa. Only 4,833 (7.4%) of Caucasian men had a FH of PCa. FH+ men had a significantly higher PCa incidence (16.9% vs. 10.8%; p< 0.01) and higher PCa specific mortality (0.56% vs. 0.37%; P< 0.01), which trended to significance in multivariate analysis (HR 1.47, 95% CI: 0.98-2.21; p=0.06). Screening FH+ men also showed a trend towards decreased PCa specific mortality with a hazard ratio of 0.49 (95% CI 0.22-1.1; p=0.08) and also a reduced time to death from PCa (log-rank; p=0.05).
CONCLUSIONS: Caucasian men with a FH of PCa are at increased risk of being diagnosed and subsequently dying from prostate cancer. Yearly digital rectal exams and PSA testing may reduce prostate cancer death in these individuals.
Liss MA, Chen H, Hemal S, Krane S, Kane CJ, Xu J, Kader AK. Are you the author?
UC San Diego Health System, Department of Urology, San Diego, CA; State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China; Wake Forest University School of Medicine, Departments of Genomics and Personalized Medicine Research, Winston-Salem, NC; Department of Urology Wake Forest University School of Medicine; UC San Diego Health System, Department of Urology, San Diego, CA.
Reference: J Urol. 2014 Jul 24. pii: S0022-5347(14)04034-8.