MADRID, SPAIN (UroToday.com) - Validation of variables which most effectively identify patients at highest risk of developing significant prostate cancer will help to distinguish those men most likely to benefit from prostate cancer screening. In this study, in order to investigate the use of positive family history as a risk stratification criterion, the authors looked at the rates of diagnosis of overall and significant prostate cancer in patients who underwent PSA screening in a prospective trial, and had first-degree relatives diagnosed with prostate cancer.
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The study looked at nearly 5 000 men who underwent PSA screening at 4-year intervals in the Swiss arm of the ERSPC trial. In total 6.8% of study participants reported a positive family history. The authors reported that these patients were 60% more likely to be diagnosed with prostate cancer when compared to those without a positive family history, which was statistically significant (OR 1.6, 95% CI 1.2-2.2, p=0.001). No difference was seen, however, with regards to PSA level, biopsy Gleason score, or d’Amico risk grouping. Family history remained a predictor of prostate cancer detection on multivariable analysis. Increased age and baseline PSA were also independent predictors of prostate cancer on multivariable analysis. The authors noted, however, that family history failed to predict the diagnosis of aggressive prostate cancer and that the majority of the cancer diagnosed in this cohort was low grade.
The authors concluded that further stratification of family history (e.g., specific relation, age at diagnosis, disease stage, and grade) may better identify patients likely to develop high-grade prostate cancer and who would benefit from more intensive PSA screening regimens.
Presented by Randazzo M, Beatrice J, Poyet C, Hermanns T, Carlsson S, Huber A, Grobholz R, Manka L, Kluth LA, Recker F, and Kwiatkowski M at the 30th Annual European Association of Urology (EAU) Congress - March 20 - 24, 2015 - IFEMA - Feria de Madrid - Madrid, Spain
Reported by Timothy Ito, MD, medical writer for UroToday.com