Incorporation of Detailed Family History from the Swedish Family Cancer Database into the PCPT Risk Calculator

Abstract

Purpose A detailed family history provides an inexpensive alternative to genetic profiling for individual risk assessment. We updated the PCPT Risk Calculator to include detailed family histories. Materials and Methods The study included 55,168 prostate cancer cases and 638,218 controls from the Swedish Family Cancer Database who were 55 years old or older in 1999 and had at least 1 male first-degree relative 40 years old or older and 1 female first-degree relative 30 years old or older. Likelihood ratios, calculated as the ratio of risk of observing a specific family history pattern in a prostate cancer case compared to a control, were used to update the PCPT Risk Calculator. Results Having at least 1 relative with prostate cancer increased the risk of prostate cancer. The likelihood ratio was 1.63 for 1 first-degree relative 60 years old or older at diagnosis (10.1% of cancer cases vs 6.2% of controls), 2.47 if the relative was younger than 60 years (1.5% vs 0.6%), 3.46 for 2 or more relatives 60 years old or older (1.2% vs 0.3%) and 5.68 for 2 or more relatives younger than 60 years (0.05% vs 0.009%). Among men with no diagnosed first-degree relatives the likelihood ratio was 1.09 for 1 or more second-degree relatives diagnosed with prostate cancer (12.7% vs 11.7%). Additional first-degree relatives with breast cancer, or first-degree or second-degree relatives with prostate cancer compounded these risks. Conclusions A detailed family history is an independent predictor of prostate cancer compared to commonly used risk factors. It should be incorporated into decision making for biopsy. Compared with other costly biomarkers it is inexpensive and universally available.

Observational study comparing the accuracy/variability between the ERSPC and the PCPT risk calculators for the prediction of significant prostate cancer in patients with PSA <10 ng/mL

“…The two most used RCs are ERSPC-RC and PCPT-RC, which have been modified and adapted 4 5. Few external validations have been conducted, with varying results 7 9 28. Usually, external validations of RCs show worse performance than the original validations,8 a fact that is corroborated by our study.…”

<p>Identification of Clinically Significant Prostate Cancer by Combined <em>PCA3</em> and <em>AMACR</em> mRNA Detection in Urine Samples</p>

“…Clinical data as results of DRE, age, tPSA and family history of PCa were obtained and used for PCa and csPCa risk evaluation by PCPTRC (Prostate Cancer Prevention Trial Risk Calculator Version 2.0, https://riskcalc.org/PCPTRC/ ). 28 , 29 One hundred and eighteen patients from the prebiopsy cohort were eligible for this analysis, 10 were excluded because of age (younger than 55) or tPSA level (higher than 50 ng/mL).…”

NCCN Guidelines Insights: Prostate Cancer Early Detection, Version 2.2016

“…Certain populations (eg, African Americans, men with a first-degree relative with prostate cancer) have a higher risk of developing prostate cancer. [38][39][40][41][42] At the meeting for the 2016 guideline update, the panel discussed the role that race and genetic susceptibility play in prostate cancer and whether or not screening recommendations should be altered for high-risk men.…”