"The groundwork of all happiness is health." - Leigh Hunt

Second- and third-degree relatives have an increased risk of prostate cancer.

By Charlie Schmidt

As is true for a lot of sorts of cancer, prostate cancer is caused partly by environmental aspects and partly by genetic aspects. Men have the next risk of developing prostate cancer if their fathers or brothers even have the disease. But does the danger also increase if a person's more distant relatives have prostate cancer?

Oh Studies published in Prostate provides a solution. Using a database spanning greater than 100 years, the Utah investigators quantified prostate cancer risk in response to three levels of association:

  • First-degree relatives, akin to parents, siblings and youngsters
  • second-degree relatives, akin to grandparents, grandchildren, uncles, nephews, or half-siblings, and
  • Third degree relatives, akin to great grandparents, great grandchildren, and first cousins.

As expected, men who had first-degree relations with prostate cancer had the very best relative risk: estimates were 2.5 times higher than if a first-degree relative was affected, in comparison with about 8 times higher. More if 4 first-degree relatives had prostate cancer. But prostate cancer in additional distant relatives was also a risk factor.

For example, a diagnosis in a person's maternal uncle (second-degree relative) nearly doubled his risk. Having a third-degree relative with prostate cancer also increases a person's risk of developing the disease. No additional risk was observed for men with a fourth-degree relative with prostate cancer.

Lisa Albright, a statistical geneticist on the University of Utah School of Medicine who led the study, said the risks are the identical no matter whether the genes are passed down from the mother or father. “It's not something people usually think about,” he said. “But if the mother's brother had prostate cancer, the nephew is also at higher risk.”

To generate the outcomes, Albright's team explored two data repositories—a genealogical database for Utah residents dating back to the Eighties, and a cancer registry for the state that dates back to 1966. Prostate cancer in multiple generations.

Dozens of family admixture risks were quantified. However, the most important findings appear in a single table “that we hope clinicians will put in their back pocket,” Albright said. Presented here, the table describes the sorts of family histories that double or triple the relative risk of prostate cancer.

Family history constellations that double or triple the danger of prostate cancer.

Relative risk greater than 2 (26% of men) Relative riskBigger than that3 (10% male)
1 affected first degree relative 2 or more affected first-degree relatives
3 or more affected second-degree relatives 5 or more affected second-degree relatives
Mother's father was affected. Both grandfathers were affected.
Nephew impressed 1 or more affected first-degree relatives and a pair of or more affected second-degree relatives
Uncles and aunts were affected. 1 or more affected first-degree relatives diagnosed before age 70.

Adapted from Albright F, Stephenson RA, Agarwal N, Teerlink CC, Lowrance WT, Farnham JM, Cannon Albright LA. Prostate cancer risk prediction based on complete prostate cancer family history. Prostate 2014, DOI: 10.1002/pros.22925

Because the evaluation is restricted to Utah residents — mostly of Northern European descent — it could actually't account for the effect of family history in other races or ethnicities, Albright acknowledged. “We hope to collaborate with others who have similar resources to work with,” he said.

Still, the findings suggest that “individuals with specific family history patterns may deserve more careful consideration with regard to screening,” said co-author Robert Stevenson, a urological surgeon on the University of Utah School of Medicine. Screening means checking apparently healthy people for signs of hidden disease. For prostate cancer, this is generally done with a prostate-specific antigen (PSA) blood test.

The US Preventive Services Task Force recommends against routine PSA testing. But he said additional research is required to find out whether the balance of advantages and harms of prostate cancer screening differs amongst men at higher risk of developing or dying from prostate cancer.