Prostate Cancer Screening Recommended Earlier for Men With Family History of the Disease

A new study in Sweden has confirmed that men with a family history of prostate cancer have a greater risk of being diagnosed with advanced or fatal disease, suggesting that screening guidelines should be adjusted to include earlier screenings in this population.

Clinical guidelines for cancer screenings are intended to identify the disease early, according to the research, which was published in PLOS Medicine. Current guidelines note that men with a family history of prostate cancer have a greater risk and should begin screenings early, although the age at which these screenings should begin has remained unclear.

To define a recommended age, investigators conducted an analysis of all male residents of Sweden born after 1931, as well as their fathers. Between 1958 and 2015, they found that 88,999 out of 6,343,727 men were diagnosed with stage 3 or 4 prostate cancer or died from the disease.

The investigators then used these data to calculate the age at which men who had a father, brother, or son diagnosed with prostate cancer reached the “screening risk threshold,” meaning the same level of prostate cancer risk as those aged 50 years and older in the broader population. They chose this threshold because many guidelines recommend that screening begin at 50 years, according to the press release.

Men with a family history of prostate cancer reached the screening risk threshold up to 12 years earlier than the general population, the researchers said. However, they noted that men reached this threshold at different ages, depending on how many of their first-degree relatives had prostate cancer and at what age those relatives were diagnosed. Based on these findings, the investigators concluded that men with a family history of prostate cancer reach a high enough risk to begin screening anywhere from 2 to 11 years earlier than is currently recommended.

These findings could be used to provide greater personalization of screening guidelines, according to the press release. Further research could help validate these results in populations of different ethnicities, while also considering genetics and lifestyle differences.

“The one-size-fits-all policy in medicine belongs to the past. More and more risk-adapted approaches are needed instead to optimize use of restricted resources in health care,” said Elham Kharazmi, MD, PhD, co-leader of the study, in the press release.

REFERENCE

When should screening start for men with a family history of prostate cancer. News release. EurekAlert. June 1, 2021. Accessed June 8, 2021. https://www.eurekalert.org/pub_releases/2021-06/p-wss052721.php