New prostate cancer risk score could help guide screening decisions

January 10, 2018

A new score for predicting a man's genetic risk of developing aggressive prostate cancer could help guide decisions about who to screen and when, say researchers in The BMJ today.

Prostate cancer is the most frequently diagnosed cancer in males in developed countries, with over a million new cases and over 300,000 associated deaths estimated worldwide in 2012.

Screening for prostate specific antigen or PSA (a cancer indicator) can lead to early detection and potentially life saving treatment. But many guidelines do not endorse universal screening due to concerns about elevated PSA in men without cancer and overtreatment for men who have cancer but might never develop aggressive disease.

Ideally, physicians would identify and screen patients at high risk of developing aggressive prostate cancer at a young age, but a practical clinically useful tool to predict age of onset is not yet available.

So researchers used data from an international study collaboration (the PRACTICAL consortium) to develop and test a genetic tool to predict age of onset of aggressive prostate cancer and to guide decisions of who to screen and at what age.

They analysed over 200,000 gene variants (known as single nucleotide polymorphisms or SNPs) from 31,747 men of European ancestry with and without prostate cancer and identified 54 associated with increased risk of prostate cancer.

These polymorphisms were incorporated into a survival analysis to estimate their effects on age at diagnosis of aggressive prostate cancer in the form of a hazard score.

The final model was then applied to data from an independent clinical trial of 6,411 men to test ("validate") prediction of survival, free from prostate cancer.

In the independent validation, the hazard score was a highly significant predictor of age at diagnosis of aggressive cancer.

Men in the top 2% of the score had an almost three-fold greater relative risk for aggressive prostate cancer compared with men with average risk.

And the researchers say that, as the score is representative of a man's fixed genetic risk, "it can be calculated once, long before onset of prostate cancer, and substantially inform the decision of whether he should undergo screening."

They point to some study limitations, and say they cannot rule out the possibility that other unmeasured factors may have influenced their results. Nevertheless, they say these results "add to existing data as further evidence that genetic features can predict risk of prostate cancer."

They add that the score "is a relatively inexpensive assessment of an individual man's age specific risk and provides objective information on whether a given patient might benefit from PSA screening."
-end-


BMJ

Related Prostate Cancer Articles from Brightsurf:

Low risk of cancer spread on active surveillance for early prostate cancer
Men undergoing active surveillance for prostate cancer have very low rates - one percent or less - of cancer spread (metastases) or death from prostate cancer, according to a recent study published in the Journal of Urology®, an Official Journal of the American Urological Association (AUA).

ESMO 2020: Breast cancer drug set to transform prostate cancer treatment
A drug used to treat breast and ovarian cancer can extend the lives of some men with prostate cancer and should become a new standard treatment for the disease, concludes a major trial which is set to change clinical practice.

Major trial shows breast cancer drug can hit prostate cancer Achilles heel
A drug already licensed for the treatment of breast and ovarian cancers is more effective than targeted hormone therapy at keeping cancer in check in some men with advanced prostate cancer, a major clinical trial reports.

The Lancet: Prostate cancer study finds molecular imaging could transform management of patients with aggressive cancer
Results from a randomised controlled trial involving 300 prostate cancer patients find that a molecular imaging technique is more accurate than conventional medical imaging and recommends the scans be introduced into routine clinical practice.

Common genetic defect in prostate cancer inspires path to new anti-cancer drugs
Researchers found that, in prostate cancer, a mutation leading to the loss of one allele of a tumor suppressor gene known as PPP2R2A is enough to worsen a tumor caused by other mutations.

First prostate cancer therapy to target genes delays cancer progression
For the first time, prostate cancer has been treated based on the genetic makeup of the cancer, resulting in delayed disease progression, delayed time to pain progression, and potentially extending lives in patients with advanced, metastatic prostate cancer, reports a large phase 3 trial.

Men taking medications for enlarged prostate face delays in prostate cancer diagnosis
University of California San Diego School of Medicine researchers report that men treated with medications for benign prostatic hyperplasia (enlarged prostate) experienced a two-year delay in diagnosis of their prostate cancer and were twice as likely to have advanced disease upon diagnosis.

CNIO researchers confirm links between aggressive prostate cancer and hereditary breast cancer
The study has potential implications for families with members suffering from these types of tumours who are at an increased risk of developing cancer.

Distinguishing fatal prostate cancer from 'manageable' cancer now possible
Scientists at the University of York have found a way of distinguishing between fatal prostate cancer and manageable cancer, which could reduce unnecessary surgeries and radiotherapy.

Researchers find prostate cancer drug byproduct can fuel cancer cells
A genetic anomaly in certain men with prostate cancer may impact their response to common drugs used to treat the disease, according to new research at Cleveland Clinic.

Read More: Prostate Cancer News and Prostate Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.