OncologyDoes Positive Family History of Prostate Cancer Increase the Risk of Prostate Cancer on Initial Prostate Biopsy?
Section snippets
Material and Methods
This is a single institutional study based on Cleveland Clinic experience. FH and all data were accessed via the institutional review board approved, Health Insurance Portability and Accountability Act-compliant, prostate cancer, and prostate biopsy databases. The FH of PCa for 4360 male patients who underwent an initial TRUS-guided PBx between March 2000 and February 2010, was reviewed and findings were subjected to two-tailed univariate and logistic regression multivariate analysis.
Candidates
Results
Overall, a total of 268 patients reported a positive FH of PCa, whereas 4092 patients had a negative FH of PCa. A total of 1976 patients (45%) had a positive initial PBx, whereas 2384 patients (55%) had a negative biopsy.
Among 268 patients with a FH positive for PCa, overall biopsy positive for PCa was found in 144 patients (54%), whereas a negative Bx was found in 124 patients (46%). Seventy-nine of 144 of these patients (55%) with positive FH of PCa were diagnosed with HGPCa, whereas 65
Discussion
As Dr. Ian Thompson has observed on many occasions, the greatest risk of being diagnosed with PCa is to undergo PBx.7 As a natural outcropping of this observation, we became concerned that the belief that FH increases the risk of PCa might simply lead to a lower threshold to perform biopsy on men with a positive FH. In the current study, univariate and multivariate analysis on 4360 patients in whom we had complete data, we found that there actually was a higher risk of prostate cancer, for both
Conclusions
In contrast to the REDUCE trial, we report that a positive FH of PCa increases the risk that North American patients undergoing initial prostate biopsy will be diagnosed with both HGPCa and LGPCa. Patients with biopsy negative for PCa, but who have a positive FH of the disease, have a significantly higher risk for being diagnosed with a high-risk pathology such as ASAP or HGPIN that increases the likelihood of a positive repeat biopsy.
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Cited by (12)
Genetics of prostate cancer and its utility in treatment and screening
2021, Advances in GeneticsCitation Excerpt :Some studies report it simply as a “yes” or “no” indicating presence or absence with no further information on number of relatives or the degree. In a single-center retrospective assessment of over 4000 men in the Cleveland clinic, men undergoing prostate biopsy following a raised PSA or abnormal DRE, a significantly higher incidence of prostate cancer (all grades) was found in men with a family history (54%) compared to those without (45%) with an OR of 1.6 (Elshafei et al., 2013). In this setting, family history was defined as ‘at least one first-degree relative (FDR) with prostate cancer (at any age).
Impact of Family History on Prostate Cancer Mortality in White Men Undergoing Prostate Specific Antigen Based Screening
2015, Journal of UrologyCitation Excerpt :Additionally, our findings are in sharp contrast to the observation that PSA screening in the entire PLCO cohort increased PCa mortality by approximately 9%.7 We report that men with a FH of PCa are more likely to be diagnosed with PCa, as previously described in this trial and in men undergoing study mandated biopsies in REDUCE (Reduction by Dutasteride of Prostate Cancer Events)9 and PCPT (Prostate Cancer Prevention Trial).10 Additionally, we noted a significant increase in death from PCa despite a low event rate (0.56% vs 0.37%, p = 0.039, HR 1.47, 95% CI 0.98–2.21, p = 0.06).
Variation in prostate cancer detection rates in a statewide quality improvement collaborative
2014, Journal of UrologyCitation Excerpt :However, our results add to this literature in 2 important ways. The overall cancer detection rate in Michigan is higher than in previous reports showing that slightly less than a third of initial prostate biopsies are positive for cancer.5–12,16,20–23 There are several potential explanations for this discrepancy.
Ethnic differences and predictors of colonoscopy, prostate-specific antigen, and mammography screening participation in the multiethnic cohort
2014, Cancer EpidemiologyCitation Excerpt :Cancer screening research that uses a more refined ethnic classification for groups that tend to be aggregated, such as Asian Americans, Pacific Islanders, and Latinos, is needed [10,15]. Family and personal medical history, access to medical care, and physician recommendations for cancer screening have all been shown to affect screening behaviors [8,11,13,16–21]. Interactions between ethnicity and these factors have emerged as areas of interest [13,22–25].
Genetic predisposition to prostate cancer: an update
2022, Familial CancerGenetics of prostate cancer
2019, Journal fur Urologie und Urogynakologie
Financial Disclosure: The authors declare that they have no relevant financial interests.