Men with family history of prostate cancer should be screened in 40s

Men with a family history of prostate cancer should be screened in their 40s to asses their risk of the illness, research suggests

  • Risk for 50-year-old generally same as for those aged 41 when at least two close family members had been previously diagnosed – one at a young age
  • Findings suggest such men should be able to take a blood test for a protein called PSA, linked to prostate cancer, while still in their early forties
  • In the UK there is no screening for prostate cancer but men over 50 can request a blood test on the NHS after speaking to their GP

Men with a family history of prostate cancer should be given early screening in their forties, research has suggested.

A study of more than 6.3million men found that their risk of late-stage or fatal prostate cancer was significantly higher when at least one close family member had previously been diagnosed.

In the UK, there is no screening for prostate cancer, but men aged 50 and over can request a blood test on the NHS after talking to their GP.

However that age cut-off may be inappropriate for men with a family history of the disease.

Researchers found the risk for 50-year-old men generally is the same as it is for much younger men aged 41, if they have at least two close relatives previously diagnosed with prostate cancer – with one at a young age.

The risk is also the same for men aged 43, if they have a father, brother or son diagnosed before the age of 60 with prostate cancer. 

The findings suggest such men should be able to take a blood test for a protein called PSA, linked to prostate cancer, while still in their early forties.

Men with a family history of prostate cancer should be given early screening in their forties, research has suggested. A study of more than 6.3million men found that their risk of late-stage or fatal prostate cancer was significantly higher when at least one close family member had previously been diagnosed. Pictured: Prostate cancer cells, 3D illustration [Stock image]

That could help them judge their risk, although experts also caution that PSA tests are not very reliable and doctors should try to avoid unnecessary treatment.

Professor Mahdi Fallah, lead author of the study from the University of Bergen in Norway, said that taking family history – which ‘can significantly affect chances of getting severe prostate cancer’ – into account ‘could help to inform future screening guidelines’.

The study led by the German Cancer Research Centre tracked men’s risk of serious stage three or four prostate cancer, or death from prostate cancer, by looking at all men born in Sweden after 1931, and their close relatives.

Around one in eight of the almost 89,000 men who developed severe or deadly prostate cancer had at least one first-degree relative – a father, brother or son – who had been previously diagnosed. 

The study, which followed the 6.3million men for decades, between 1958 and 2015, worked out that men aged 50 had odds of one in 500 that they will develop serious prostate cancer in the next decade of their lives.

This was set as the threshold for screening, as so many countries, including the UK, offer men testing for prostate cancer from the age of 50.

But men with at least one close relative diagnosed with prostate cancer before 60 met the one-in-500 risk threshold seven years earlier.

That suggests they should be tested aged 43. Similarly, men with at least two first-degree relatives diagnosed with prostate cancer, the youngest of which was diagnosed before 60, met the threshold aged 41.

If the youngest relative was diagnosed above the age of 60, the findings suggest the age of screening should also be 43.

The UK does not have a screening programme for prostate cancer as PSA tests regularly falsely show men to be positive for cancer. 

However the NHS has an ‘informed choice’ programme, so that healthy men aged 50 and over can talk to their GP about the pros and cons of a PSA test.

Authors of the new study, published in the journal PLOS Medicine, suggest that doctors should ask men about their close relatives and their age of prostate cancer diagnoses.

Screening for prostate cancer is hoped to be possible in the future, with scientists working on innovations such as MRI scans which could be more accurate – although experts warn that screening can lead to men with slow-growing cancers being given damaging treatments they do not need.

The UK does not have a screening programme for prostate cancer as PSA tests regularly falsely show men to be positive for cancer. However the NHS has an ‘informed choice’ programme, so that healthy men aged 50 and over can talk to their GP about the pros and cons of a PSA test [Stock image]

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