Prostate cancer (PCa) is the most frequently diagnosed cancer in men worldwide. As PCa is a complex, multigenic disease, it has been challenging to establish its genetic basis, with strong risk factors obscured by the genetically heterogeneous patient populations often available for analysis. Worldwide the PCa phenotype has been further complicated based on the frequent inclusion of cases in which prostate specific antigen (PSA)-tests allow early diagnosis of possibly latent disease. Thus, previous segregation analyses have variously suggested that the familial aggregation of PCa follows autosomal dominance, recessive or X-linked inheritance, but remain inconclusive. The objective of this study was to assess the familial aggregation of PCa in a sample of 1,546 nuclear families ascertained through an affected father and diagnosed during [1988][1989][1990][1991][1992][1993]
NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author Manuscript segregation analysis on two cohorts of 557 early-onset and 989 late-onset families with clinically diagnosed PCa cases, uncomplicated by predictions from PSA screening. We evaluated residual paternal effects, assuming that age at diagnosis followed a logistic distribution after logtransformation. Our results indicate that Mendelian recessive inheritance consistent with the sexlimited X-linked region previously mapped in Finnish families to the HPCX locus best fit the data in each cohort. With a putative high-risk allele frequency qA of 0.09 in the combined analysis, genotype-specific mean ages at diagnosis of 63.6 years for AA and 71.0 years for AB/BB, respectively, were obtained. The significant paternal regressive coefficient was also indicative of a polygenic multifactorial component, suggesting that environmental factors may contribute to the rising incidence of PCa in Finland.