Family history, race, and prostate cancer.

2017 ◽  
Vol 35 (6_suppl) ◽  
pp. 225-225
Author(s):  
Joshua Schiff ◽  
Elisa M. Ledet ◽  
Emma M. Ernst ◽  
Cathryn E. Garvey ◽  
Patrick Cotogno ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Gleason Score ◽  
Cancer Center ◽  
Clinical Factors ◽  
Degree Relative ◽  
Chi Square ◽  
Clinical Correlates ◽  
Incidence And Mortality ◽  
N 93

225 Background: African American (AA) race and family history (FH) of prostate cancer (PCa) increase the incidence and mortality of PCa. The goal of this study was to assess and compare FH in AA and Caucasian (C) men. Methods: During June 2015 through September 2016, 338 men with prostate cancer had FH collected at Tulane Cancer Center (C = 266 and AA = 72). A FH was defined as ≥ 1 1st degree relative with PCa and/or ≥ 2 affected 2nd/3rddegree relatives. Documented clinical factors were age at diagnosis (dx), Gleason score, incidence of radical prostatectomy (RP), and presence of metastases (at any time). Chi-square and Mann-Whitney U tests were performed to identify potential clinical correlates with regard to FH and race. Results: For demographics see table below. On average, men with a FH of PCa (n = 110) had a median age at dx of 59.6 as compared to those without a FH of PCa (n = 151) (median age at dx = 63.0). Overall FH patients (pts) were younger at dx (p = 0.00046). FH had a particularly impactful influence upon the age at dx for C men (p = 0.00086, 58 [n = 88] vs. 62.5 [n = 112]); statistics were limited for AA men. Gleason scores were not different between pts with or without a FH, and there was no relationship between Gleason score and race. Metastatic disease (mets) was detected in 23.97% of men (n = 93). C men with a FH of PCa (n = 40) were 1.55 times more likely to develop mets (p = 0.0352). AA data were limited so no comment can be made. No relationship was detected between the pts having undergone a RP and race, but pts with a FH of PCa (n = 61) were 1.39 times more likely to have undergone surgery (p = 0.016). Data by racial subsets were too limited to be conclusive. Conclusions: The study highlighted the significant impact that FH of PCa has upon age at dx and presence of mets. More AA data are needed to be conclusive. [Table: see text]

Clinical differences between African-Americans (AA) and Caucasians (CA) with and without family history (FH) of prostate cancer.

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 279-279
Author(s):  
Cathryn E. Garvey ◽  
Patrick Cotogno ◽  
Emma M. Ernst ◽  
Elisa M. Ledet ◽  
A. Oliver Sartor
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Gleason Score ◽  
Metastatic Disease ◽  
Clinical Factors ◽  
Single Institution ◽  
Degree Relative ◽  
Chi Square ◽  
Clinical Correlates ◽  
Relevant Covariates

279 Background: Prostate cancer is one of the most common adult malignancies. Two well characterized risk factors for prostate cancer (PCa) are family history (FH) and race. The goal of this study was to distinguish the influence of family history and race with regards to clinically relevant covariates. Methods: In this single-institution study, 497 PCa patients from Tulane Hospital were clinically annotated and FH was evaluated. FH was defined as having ≥ 1 first degree relative affected with PCa and/or ≥ 2 affected second or third degree relatives. There were 147 AA and 350 CA patients; 66 AA and 120 CA reported PCa FH. The following clinical factors were documented: age and PSA at diagnosis (dx), Gleason score (biopsy or radical prostatectomy), and presence of metastasis (at any time). Chi-square, ANOVA, and odds ratio tests were performed to identify potential clinical correlates with regard to FH and race. Results: Results indicate that race and FH are not independent (p = 0.0266), where AAs were 1.5 times more likely to have a FH of PCa than CAs (95% CI 1.0543-2.3133). On average, men with a FH of PCa were younger at dx (p = 0.0063). FH significantly impacted age at dx for AAs (p = 0.036) but not CAs. No difference in age of dx was detected between race. FH of PCa did not influence PSA at dx in either CA (6.5, 1.2-681) or AA (19.2, 1.7-500) men, however race did (p = 0.004). CAs with FH of PCa were more likely to be diagnosed with low or intermediate risk PCa (Gleason score ≤ 7, p = 0.03). Gleason scores were not significantly different between races. Overall, FH did not influence metastasis. Although, AAs (n = 19) were 1.61 times more likely to develop metastatic disease compared to CA men. Conclusions: For AAs, FH lowered age at dx but did not have influence on development of metastatic disease, Gleason score or PSA. For CAs, Gleason score was lower in men with a FH. Overall AAs, as compared to CAs had more metastatic disease and higher PSAs at dx. Continuing to track clinical differences between AAs and CAs with a FH of PCa may provide additional insights into underlying racial and clinical disparities.

Germline pathologic mutations and cancer family history in prostate cancer patients.

2018 ◽  
Vol 36 (6_suppl) ◽  
pp. 378-378
Author(s):  
Marcus Marie Moses ◽  
Elisa Ledet ◽  
Emma M. Ernst ◽  
Patrick Cotogno ◽  
Joshua Schiff ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
San Francisco ◽  
Treatment Options ◽  
Distant Metastases ◽  
Cancer Center ◽  
Chi Square ◽  
Variant Of Uncertain Significance ◽  
Pathogenic Variants ◽  
Uncertain Significance

378 Background: Prostate cancer (PCa) patients (pts) with metastases and/or strong family history (FH) of cancer (Ca) are at higher risk of a germline mutation. The identification of alterations in PCa pts may be important for risk stratification as well as personalizing treatment options. The goal of this study was characterization of FH and pathogenic variants (PV) detected in PCa pts, with both localized and metastatic disease. Methods: 300 PCa pts from Tulane Cancer Center underwent germline testing. 265 Caucasian (C) and 35 African-Americans (AA) were tested and met the NCCN criteria for testing and/or had distant metastases (mets). Germline genetic testing was done via commercial panels (30-80 genes) (Invitae. San Francisco, Ca). PCa pts had extensive FH screening. Clinical annotation included age at diagnosis (dx), race, and presence of mets at any time. Chi square tests were used to compare clinical correlates and PVs. Results: Of the 300 pts tested, 182 pts (60.6%) had mets and 118 (39.4%) did not. 41 pts (13.6%) had ≥ 1 germline pathogenic variant (PV) and 161 pts (53.6%) had ≥ 1 germline variant of uncertain significance (VUS). PVs were detected in BRCA2 (n = 10), MUTYH (n = 8), CHEK2 (n = 6), BRCA1 (n = 4), ATM (n = 4), TP53 (n = 3), PMS2 (n = 2), BLM (n = 2), MITF (n = 2), NBN (n = 1), and RAD51D (n = 1). MUTYH and MITF are not known to be linked to prostate cancer. There was no significant relationships in FH PCa and FH non-PCa in regard to likelihood of a PV (p = .86 and p = .18). Of the 300 pts tested, 136 pts (45.3%) had PCa FH, 131 pts (43.6%) had breast Ca FH, 61 pts (20.3%) had lung Ca FH, 61 pts (20.3%) had colon Ca FH, 37 pts (12.3%) had pancreatic Ca FH, and 32 pts (10.6%) had ovarian Ca FH. 45.6% of C men (n = 121) and 42.8% of AA men (n = 15) had PCa FH. Pts with a non-PCa FH (n = 255) were 1.37 times more likely to develop mets (p = .01168). The median age of dx were 61 for PV pts, 62 for VUS pts, and 61 for negative pts (non-significant). 21/182 pts with mets (11.5%) had a PV; 8/182 (4.4%) pts with mets had a BRCA2 PV. Conclusions: In metastatic patients, FH of prostate cancer alone cannot predict those with PV. The most common Cas observed in these pts were breast, lung, colon and pancreatic. A larger cohort is needed to fully characterize and understand the co-segregation of PCa with other Cas.

Family history of prostate cancer in patients with localized prostate cancer: an independent predictor of treatment outcome.

1997 ◽  
Vol 15 (4) ◽  
pp. 1478-1480 ◽  
Author(s):  
P A Kupelian ◽  
V A Kupelian ◽  
J S Witte ◽  
R Macklis ◽  
E A Klein
Keyword(s):  
Prostate Cancer ◽  
Treatment Outcome ◽  
Family History ◽  
Treatment Modality ◽  
Proportional Hazards ◽  
Positive Family History ◽  
Specific Antigen ◽  
Tumor Stage ◽  
Degree Relative ◽  
History Of

PURPOSE To determine if familial prostate cancer patients have a less favorable prognosis than patients with sporadic prostate cancer after treatment for localized disease with either radiotherapy (RT) or radical prostatectomy (RP). PATIENTS AND METHODS One thousand thirty-eight patients treated with either RT (n = 583) or RP (n = 455) were included in this analysis. These patients were noted as having a positive family history if they confirmed the diagnosis of prostate cancer in a first-degree relative. The outcome of interest was biochemical relapse-free survival (bRFS). We used proportional hazards to analyze the effect of the presence of family history and other potential confounding variables (ie, age, treatment modality, stage, biopsy Gleason sum [GS], and initial prostate-specific antigen [iPSA] levels) on treatment outcome. RESULTS Eleven percent of all patients had a positive family history. The 5-year bRFS rates for patients with negative and positive family histories were 52% and 29%, respectively (P < .001). The potential confounders with bRFS rates were iPSA levels, biopsy GS, and clinical tumor stage; treatment modality and age did not appear to be associated with outcome. After adjusting for potential confounders, family history of prostate cancer remained strongly associated with biochemical failure. CONCLUSION This is the first study to demonstrate that the presence of a family history of prostate cancer correlates with treatment outcome in a large unselected series of patients. Our findings suggest that familial prostate cancer may have a more aggressive course than nonfamilial prostate cancer, and that clinical and/or pathologic parameters may not adequately predict this course.

Is systematic 10 core prostate needle biopsy enough for treatment determination of localized prostate cancer?

2012 ◽  
Vol 30 (5_suppl) ◽  
pp. 163-163
Author(s):  
Ryo Kishimoto ◽  
Ryuta Tanimoto ◽  
Kensuke Bekku ◽  
Yasuyuki Kobayashi ◽  
Shin Ebara ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Multivariate Analysis ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Needle Biopsy ◽  
Chi Square ◽  
Prostate Needle Biopsy ◽  
Significant Difference ◽  
Chi Square Test

163 Background: To evaluate whether the systematic 10 cores prostate needle biopsy is enough for determination of NCCN risk classification (NRC), we analyzed migration of Gleason score (GS), cancer location, and NRC between pre and postoperative periods in a cohort of patients who underwent radical prostatectomy. Methods: A total of 197 patients were included in this study. These patients were divided into three groups along the number of biopsy cores: less than 10 (L), 10, and more than 10 (M). We compared between three groups about Gleason score, cancer location and NCCN risk classification change (CC) between prostate biopsy and radical prostatectomy specimen. Statistical analysis were performed with chi-square test, and multiple logistic regression with p<0.05, and Bonferroni correction with p<0.017 considered significant difference. Results: The rate of CC in L, 10, M was 55.1%, 43.0%, 26.5%, respectively. On chi-square test rates of CC were significantly different between three groups (P=0.035), but rates of Gleason score and cancer location were not. On univariate analysis, PSA (Odds rate (OR) 0.872 p<0.001), preoperative NRC (low vs. intermediate, and poor, OR 0.157 and 0.241, p<0.001), prostate volume (normal vs. mild or moderate, OR 1.989 p=0.025), the number of biopsy cores (L vs. M, OR 0.293 p=0.011), GS (6 vs. 8, OR 2.374 p=0.021) were correlated with CC. On multivariate analysis, the most important independent predictive factors for CC were preoperative NRC (low vs. intermediate, p<0.001, OR 0.198, 95% CI 0.09-0.45) and PSA (p=0.007, OR 0.903, 95%CI 0.83-0.98), but the number of biopsy cores was not associated CC significantly. Conclusions: Although multivariate analysis showed no significant difference, the more biopsy cores reduced the risk of CC. Systematic 10 core biopsy might be insufficient for accurate diagnosis and treatment decision of prostate cancer.

Advancing age and the risk of adverse pathology at radical prostatectomy in men with biopsy Gleason score 6 prostate cancer.

2020 ◽  
Vol 38 (6_suppl) ◽  
pp. 289-289
Author(s):  
Daniel Kim ◽  
Ming-Hui Chen ◽  
Hartwig Huland ◽  
Markus Graefen ◽  
Derya Tilki ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Radical Prostatectomy ◽  
Gleason Score ◽  
Specific Antigen ◽  
Cancer Center ◽  
Study Cohort ◽  
Pathologic Features ◽  
Younger Men ◽  
Biopsy Gleason Score ◽  
The Impact

289 Background: We evaluated the impact of age > 65 years versus younger on the odds of finding adverse pathologic features (pT3/T4 and/or R1 and/or Gleason score 8, 9, 10) at radical prostatectomy (RP) among men with biopsy Gleason score 6 prostate cancer (PC). Methods: The study cohort comprised 3191 men with biopsy Gleason score 6 PC treated with a RP between February 28, 1992 and February 15, 2016 at the Martini-Klinik Prostate Cancer Center. Multivariable logistic regression was used to evaluate the impact of age > 65 years versus younger on the adjusted odds ratio (AOR) of finding adverse pathology at RP adjusting for pre-RP prostate specific antigen (PSA), clinical tumor category, year of diagnosis, percent positive biopsies (PPB), and PSA density (PSAd). Results: Men age > 65 years as compared to younger had significantly lower median PPB (16.67% vs 20.0%; p = 0.01) and PSAd (0.13 ng/mL vs 0.15 ng/mL; p < 0.0001). Yet, while both increasing PPB (AOR 1.018, 95% CI 1.013, 1.023; p- < 0.0001) and PSAd (AOR 4.28, 95% CI 1.66, 11.01; p = 0.003) were significantly associated with an increased odds of finding adverse pathology at RP, men age > 65 years versus younger had a higher odds of adverse pathology at RP (AOR 1.28, 95% CI 1.002, 1.62; p = 0.048). Conclusions: Despite a more favorable median PPB and PSAd, men with biopsy Gleason score 6 PC and who are age > 65 years compared to younger men are at higher risk for having adverse pathology at RP and may benefit from a multiparametric MRI and targeted biopsy before proceeding with active surveillance. If higher grade/stage disease is discovered and treatment indicated then this information could guide both the use and duration of supplemental androgen deprivation therapy in men considering radiation therapy.

scholarly journals Absence of history of oral cleft in first-degree relatives of patients with prostate cancer

2019 ◽  
Vol 7 (1) ◽  
Author(s):  
Cláudia De Alvarenga Diniz Fonseca ◽  
Daniella Reis Barbosa Martelli ◽  
Ianná Luana Freitas Almeida ◽  
Galeno Hassen Sales ◽  
Rodrigo Soares de Andrade ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Cleft Lip ◽  
Control Group ◽  
Chi Square ◽  
Exact Test ◽  
First Degree Relatives ◽  
History Of ◽  
Risk Magnitude ◽  
Magnitude Assessment

Objective: To evaluate the occurrence of nonsyndromic cleft lip and/or palate (NSCL/P) in families of patients with prostate cancer (PC).Study design: We conducted a case-control study involving a total of 748 individuals, 280 of which had PC, and 468 were free-cancer healthy individuals. The patients answered a questionnaire with basic demographic information and family history of NSCL/P in first-degree relatives. The information collected was stored in a database and analyzed by using the statistical program SPSS® 24.0 for Windows (Chicago, IL, USA). In order to determine the association with NSCL/P, chi-square and Fisher’s exact test and odds ratio (OR) with its 95% confidence interval (95% CI) for risk magnitude assessment. Values with p<0.05 were considered statistically significant.Results: Of total patients with PC, 2 had a positive history of NSCL/P. In the control group, 7 patients reported family history of NSCL/P (1df chi-square, p=0.34; Fisher´s exact test, p=0.49). The average age of the cases diagnosed with PC was 71.35±7.70 years, and control group was 64.42±9.67 years.Conclusion: Despite the limited population, the frequency of NSCL/P was not significantly increased in the first-degree relatives of patients with PC. Studies with larger samples and molecular analyses are needed to better understand the possible relationships in the etiology of cancer and NSCL/P.

Potential predictors of fear of progression among long-term prostate cancer survivors: Do illness perceptions and family history matter?

2012 ◽  
Vol 30 (15_suppl) ◽  
pp. e15157-e15157
Author(s):  
Kathleen Herkommer ◽  
Astrid Hahn ◽  
Andreas Dinkel ◽  
Birgitt Marten-Mittag ◽  
Peter Herschbach ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Illness Perceptions ◽  
Short Form ◽  
Negative Emotions ◽  
Illness Perception ◽  
Economic Situation ◽  
Degree Relative ◽  
Fear Of Progression ◽  
Time Since Diagnosis

e15157 Background: Fear of illness progression (FoP) or recurrence is known to be one of the most prominent fears in patients with prostate cancer (PCa) even years after treatment. To improve detection of men at risk, possible predictors need to be discovered. So far, little is known about the influence of patients' illness perceptions (IP) and family history on dysfunctional FoP (dysFoP). Methods: A nationwide mail survey was sent out to a total of 6.305 men who had been treated with radical prostatectomy. Median time since diagnosis was 7.4 years. Patients were divided into 2 subgroups according to their family history: 68.9% (n=4.341) sporadic and 31.1% (n=1.964) familial (at least 1 first-degree relative with PCa). FoP was assessed with the short form of the Fear of Progression Questionnaire (FoP-Q-SF), IP were assessed with the Brief Illness Perception Questionnaire (B-IPQ). We also evaluated sociodemographic and clinical parameters and their influence on FoP. Results: Dysfunctional FoP was identified in 3.4% of all patients. Patients worried most about family, being dependent on others, and whether the children would also be diagnosed with PCa. Younger age, worse subjective economic situation, shorter time since diagnosis and disease progression were significantly associated with dysFoP (p<.01). IP and prevalence of dysFoP did not differ significantly between patients with sporadic and familial PCa, but familial PCa was associated with a higher mean level of FoP. IP explained a high amount of variance in FoP (R²=.435). Stronger perceptions of worry and negative emotions were significant predictors of FoP (p<.001). Furthermore, having at least one son (p=.004), time since diagnosis <5 years (p=.006) and worse subjective economic situation (p=.030) were predictive of dysFoP. Conclusions: In this study only a minority of patients reported dysFoP. The study findings suggest the importance of addressing IP, especially worries, negative emotions, and perceived consequences as key factors of FoP. Prevalence of dysFoP did not differ depending on family history, however patients with familial PCa showed higher mean levels of FoP.

Risk for death from prostate cancer predicted from complete family history of lethal prostate cancer (LPC).

2015 ◽  
Vol 33 (7_suppl) ◽  
pp. 175-175
Author(s):  
Frederick S. Albright ◽  
Neeraj Agarwal ◽  
William Thomas Lowrance ◽  
Robert A Stephenson ◽  
Anitha Alex ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Family History ◽  
Cancer Registry ◽  
Death Certificate ◽  
Population Data ◽  
Expected Number ◽  
Degree Relative ◽  
Increased Risk ◽  
History Of ◽  
Lethal Prostate Cancer

175 Background: There are few published reports of relative risk (RR) for LPC based on family history of prostate cancer (PC) lethality. This study provides LPC RR using complete LPC family history data obtained from a statewide Cancer Registry linked to a genealogy database. Methods: The Utah Population Data Base (UPDB), which includes a statewide SEER cancer registry, includes 1,192,768 individuals with at least 12 of their 14 immediate ancestors. All males (probands) with specific LPC constellations were identified in the UPDB, and the observed number of LPC cases among these probands was compared to the expected number of LPC cases using internal cohort-specific rates from Utah death certificates including all deceased males with no 1st, 2nd, or 3rd degree relatives with LPC. LPC Family history was estimated for 1st degree to 3rd degree relatives for: number of LPC relatives affected, paternal versus maternal family history, and age at first PC diagnosis. Results: 3,921 individuals in UPDB were diagnosed with histologically confirmed PC, and had a Utah death certificate indicating PC as a cause of death and were designated LPC. The RR for LPC was significantly elevated with each additional first-degree relative (FDR) with LPC; even in the absence of FDR family history of LPC, significantly increased risk for LPC was observed in the presence of at least 1 LPC affected second degree relative (SDR). In the absence of positive FDR and SDR family history for LPC, there was still increased risk for LPC for males with 2 or more third degree relatives with LPC. Early age PC diagnosis in the LPC relative did not appear to affect LPC RR. Higher risks of LPC were associated with the maternal compared to the paternal lineages. Conclusions: Examination of lethal prostate cancer family history (in FDRs through TDRs) may be useful in identifying the cohort of men with prostate cancer most at risk for death from prostate cancer. Focused screening and treatment of this cohort holds potential to decrease the rates of undertreatment of lethal disease while avoiding over diagnosis and overtreatment in inconsequential disease.

Does increasing number of core biopsies change the results of needle biospy in prostate cancer?

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 113-113
Author(s):  
M. H. Farhat ◽  
A. Dabaja ◽  
P. Agarwal
Keyword(s):  
Prostate Cancer ◽  
Risk Factors ◽  
Gleason Score ◽  
Core Biopsy ◽  
Perineural Invasion ◽  
Standard Of Care ◽  
Chi Square ◽  
Prostate Biopsies ◽  
Match Rate ◽  
Chi Square Test

113 Background: The superiority of extended sampling of the prostate compared to standard sextant biopsy in predicting the final Gleason score has been controversial. In the literature, sextant biopsies have a match rate between 28–68% and an upgrading rate of 25–57%. Consequently, multiple studies recommend that extended biopsies should be the standard of care. This study examines the effect of greater core biopsy number on upgrading GS and predicting surgical pathology. Methods: Prostate biopsies of 984 patients who underwent RP between 2001 and 2008 were retrospectively reviewed. The GS of the biopsies was compared to the pathological specimens using the Chi-square test. Further adjusted comparison was performed using logistic regression. A clinical significant upgrade was defined as increase of the total GS or the primary GS. Results: The majority of the upgrading occurred in biopsy Gleason 3+3 and 3+4 cases. Upgrading was seen in 35.1% of patients with 6 cores or less, 34.5% with 7–12 cores, and 45.5% with 13+ cores (p=0.061). Number of cores, BMI, or prostate size did not affect upgrading, while perineural invasion, cancer volume on a biopsy, and D'Amico risk criteria increased the likelihood of upgrading. Conclusions: The extended core biopsy does not seem to correlate with higher gleason score or to better predict the final pathologic gleason score compared to standard sextant biopsies in prostate cancer. D'Amico risk factors, perineural invasion, and cancer volume can be viewed as risk factors for upgrading especially in GS 3+3. No significant financial relationships to disclose.

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