Defining the Impact of Family History on Detection of High-grade Prostate Cancer in a Large Multi-institutional Cohort

Matthew B. Clements, Emily A. Vertosick, Lourdes Guerrios-Rivera, Amanda M. De Hoedt, Javier Hernandez, Michael A. Liss, Robin J. Leach, Stephen J. Freedland, Alexander Haese, Francesco Montorsi, Stephen A. Boorjian, Cedric Poyet, Donna P. Ankerst, Andrew J. Vickers

Research output: Contribution to journalArticlepeer-review

14 Scopus citations

Abstract

Background: The risk of high-grade prostate cancer, given a family history of cancer, has been described in the general population, but not among men selected for prostate biopsy in an international cohort. Objective: To estimate the risk of high-grade prostate cancer on biopsy based on a family history of cancer. Design, setting, and participants: This is a multicenter study of men undergoing prostate biopsy from 2006 to 2019, including 12 sites in North America and Europe. All sites recorded first-degree prostate cancer family histories; four included more detailed data on the number of affected relatives, second-degree relatives with prostate cancer, and breast cancer family history. Outcomes measurements and statistical analysis: Multivariable logistic regressions evaluated odds of high-grade (Gleason grade group ≥2) prostate cancer. Separate models were fit for family history definitions, including first- and second-degree prostate cancer and breast cancer family histories. Results and limitations: A first-degree prostate cancer family history was available for 15 799 men, with a more detailed family history for 4617 (median age 65 yr, both cohorts). Adjusted odds of high-grade prostate cancer were 1.77 times greater (95% confidence interval [CI] 1.57−2.00, p < 0.001, risk ratio [RR] = 1.40) with first-degree prostate cancer, 1.38 (95% CI 1.07−1.77, p = 0.011, RR = 1.22) for second-degree prostate cancer, and 1.30 (95% CI 1.01−1.67, p = 0.040, RR = 1.18) for first-degree breast cancer family histories. Interaction terms revealed that the effect of a family history did not differ based on prostate-specific antigen but differed based on age. This study is limited by missing data on race and prior negative biopsy. Conclusions: Men with indications for biopsy and a family history of prostate or breast cancer can be counseled that they have a moderately increased risk of high-grade prostate cancer, independent of other risk factors. Patient summary: In a large international series of men selected for prostate biopsy, finding a high-grade prostate cancer was more likely in men with a family history of prostate or breast cancer.

Original languageEnglish
Pages (from-to)163-169
Number of pages7
JournalEuropean Urology
Volume82
Issue number2
DOIs
StatePublished - Aug 2022

Keywords

  • Biopsy
  • Breast cancer
  • Diagnosis
  • Family history
  • Prostate cancer

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