Increased risk of prostate cancer in men with the BRCA2 gene

According to researchers funded by Cancer Research UK, men with the BRCA2 gene have an increased risk of prostate cancer and could benefit from prostate specific antigen (PSA) tests to help detect the disease earlier.

Previous studies have shown that PSA is not a suitable test for detecting prostate cancer in the general population, and this remains the case. The APS test has limitations, including false positives, false negatives and overdiagnosis.

But new research has shown that PSA tests were more likely to detect more severe forms of prostate cancer in men carrying the BRCA2 gene than in non-carriers – suggesting that these men might benefit from a regular PSA test.

In the study published today in European urology, researchers at the London Cancer Institute, examined about 1,400 men and compared those who do not carry the BRCA2 gene to those who carry it.

Men were offered a PSA test each year and, depending on the outcome, were offered either a biopsy to confirm their illness and were treated if necessary, or asked to return the following year.

The researchers found that men with the BRCA2 gene were almost twice as likely to develop prostate cancer as non-carriers.

They also found that carriers had been diagnosed at an earlier age – 61 years on average, compared to 64 in non-carriers.

It is important to note that more serious tumors were diagnosed in men carrying the BRCA2 gene, with 77% of them suffering from a clinically significant disease versus 40% of non-carriers.

The study was not able to determine whether the PSA test reduced the number of men who died from prostate cancer, which is necessary to prove the number of men who died from prostate cancer. benefit of screening in all groups.

Several factors can increase PSA levels, including prostate enlargement, certain medications, urinary tract infections or recent ejaculation.

And receiving a false positive result can lead to unnecessary worry and unnecessary biopsies.

This research provides more evidence that the BRCA2 flaw increases the risk of prostate cancer in humans and shows that a better test is needed to diagnose it.

The BRCA1 and 2 genes are associated with an increased risk of breast and ovarian cancer. But we know less that BRCA2's fault also increases the risk of prostate cancer, although we do not know exactly how much.

It is estimated that about 1 in 300 men would carry the gene, but only some of them will develop prostate cancer.

Professor Rosalind Eeles, Professor of Oncogenetics at the Institute of Cancer Research in London and clinical oncology consultant at the Royal Marsden NHS Foundation Trust, head of the study, said: "For women who undergo genetic testing, options available to them if BRCA error, including preventative surgery and increased screening, but there is no prevention path in place if men decide to determine if they carry viruses, which is why our research is so important.

"Men can be tested for BRCA fever because of a family history of breast cancer because they could pass on the gene to their children, which is especially important if they have girls." And our research allow this group of men to better understand their own health situation.

"Based on our findings, we recommend offering men who experience a failure in regular BRCA2 PSA tests, so that they can be diagnosed and treated sooner."

Professor Charles Swanton, Chief Clinician at Cancer Research UK, said, "Understanding more about people at risk for prostate cancer is an extremely important area of ​​research.

"Previous studies have shown that PSA is not an appropriate test for detecting prostate cancer in the general population, but we still need to understand whether the PSA test would reduce deaths from the disease in the general population. groups at high risk before making a recommendation.

"All physicians want the best for their patients and do not want to leave anything to chance." Some may explain the potential risks associated with the APS test and recommend it to patients who are not sure. At-risk groups, even if they do not know that it will reduce the number of deaths, worry about their risk of prostate cancer or have a family history should discuss with their doctor. "