A man’s prostate cancer risk depends on how many of his first-degree relatives were diagnosed with the malignancy, according to researchers. In general, the risk also decreases with increasing age.

 “The present results should guide clinical counseling and demonstrate the vast increases in risk when multiple first-degree relatives are affected,” the authors wrote in European Urology (2010; published online ahead of print).

Compared with men who had no affected relatives, men younger than 65 years with affected brothers had a 23 times increased risk of a prostate cancer diagnosis, the highest risk in the study population, the study found. Men aged 54 years or younger with one affected brother and an affected father had an 11 times increased risk. Men aged 65 to 74 years with an affected father had a 78% increased risk, the lowest risk among men with affected relatives.

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In addition, compared with men with no affected relatives, men with an affected father had an 81% increased risk of death from prostate cancer. Subjects with one affected brother had a 2.7 times increased risk. Those with an affected father and two affected brothers had a nearly 10-fold increased risk of prostate cancer death. Men had a twofold increased risk of death from prostate cancer if they had father or brother who died from the disease and a sixfold increased risk if they had a father and brother who died from prostate cancer.

The findings, by Andreas Brandt, PhD, of the German Cancer Research Centre in Heidelberg, and colleagues, are based on a study of data from the nationwide Swedish Family-Cancer Database. The study is the largest of its kind yet published. It included 26,651 prostate cancer patients, of whom 5,623 were familial.