Family history of prostate cancer means little

NEW YORK (Reuters Health) - Contrary to some earlier studies, the results of more recent studies no longer support the notion that prostate cancers in men with a family history of the disease behave more aggressively than "sporadic" cancers in men with no family history.

Dr. Patrick A. Kupelian from the M. D. Anderson Cancer Center in Orlando, Florida and associates studied the aggressiveness of sporadic versus familial prostate cancer in 4112 men.

The analysis was performed for two time periods -- 1986 to 1992 and 1993 to 2002 -- to encompass the period when prostate-specific antigen (PSA) testing was fairly uncommon and the more recent period when PSA testing became more widespread and routine.

The team reports in the Journal of Clinical Oncology that, overall, 16 percent of the men had a family history of prostate cancer. Family history was associated with treatment failure only in the early PSA era, the investigators report. Men with a family history had "more favorable" disease in the later PSA period.

This means that with more routine PSA testing, prostate cancers are being detected at an earlier stage, Kupelian and his colleagues suggest, so that, along with improved therapy, the impact of family history on prognosis has become "minimal."

The researchers' analysis "failed to reveal family history as an independent predictor of relapse."

Ultimately, "the importance of any difference in the clinical behavior of familial prostate cancer seems small in patients diagnosed and treated in more recent years," conclude the investigators.

"However," they point out, "underlying genetic factors affecting prostate cancer behavior in individuals with familial prostate cancer may still be important in determining individual prognosis."

SOURCE: Journal of Clinical Oncology, July 20, 2006.