Family history of prostate cancer (PCa) is unlikely to be a reason to exclude men from active surveillance (AS) for low-risk PCa, researchers reported.
In a systematic review of 6 observational studies conducted before March 2016, Jim Dupree, MD, Jaya Marie Telang, and colleagues found no significant relationship between PCa progression risk and a family history of PCa among patients on AS or eligible for it. However, a study by Eugene Pietzak, MD, and colleagues published in Urology (2015;85:436-440) found that black men with a family history of PCa did have increased risks of aggressive pathology.
“Our results suggest that having a family history of prostate cancer should not automatically exclude men from being considered for active surveillance treatments, although some questions remain about risks for African American men with a family history of prostate cancer,” Dr Dupree, of the University of Michigan in Ann Arbor, told Renal & Urology News.
The studies varied in their definition of PCa progression, the authors acknowledged in a paper published online ahead of print in BJU International. Four studies relied on results from biopsy-detected pathology and 2 studies on serum biomarkers, such as PSA, PCa antigen 3 (PCA3), and transmembrane protease and serine 2 fusion (TMPRSS2-ERG).
Given the small numbers of patients, the investigators were unable to examine fully the role of race and genetic markers for PCa. “More research needs to be done to confirm these findings, especially among African American men,” Dr Dupree stated. “Men obviously need to have thorough conversations with their doctors about risks, benefits, and options.”
1. Telang JM, Lane BR, Cher ML, Miller DC, Dupree JM. Prostate cancer, family history, and eligibility for active surveillance: A systematic review of the literature. BJUI. DOI: 10.1111/bju.13862 [Epub]