J Urol. 2014 Jul 24. pii: S0022-5347(14)04034-8. doi: 10.1016/j.juro.2014.07.085. [Epub ahead of print]
Impact of Family History on Prostate Cancer Mortality in Caucasian Men Undergoing PSA-Based Screening.
To assess if prostate cancer (PCa) screening reduces PCa mortality in Caucasian men with a family history (FH) of prostate cancer.
MATERIALS AND METHODS:
Data from the Prostate, Lung, Colorectal, and Ovarian (PLCO) screening trial was used to compare screening and usual care arms within the subset of men with and without a FH of PCa. Univariate, multivariate cox regression analysis, and log-rank analysis of Kaplan-Meier curves were used to examine the data for differences in PCa specific survival.
A total of 65,179 Caucasian subjects were included in the PSA screening trial, of which 7314 (11.2%) were diagnosed with PCa. Only 4,833 (7.4%) of Caucasian men had a FH of PCa. FH+ men had a significantly higher PCa incidence (16.9% vs. 10.8%; p<0.01) and higher PCa specific mortality (0.56% vs. 0.37%; P<0.01), which trended to significance in multivariate analysis (HR 1.47, 95% CI: 0.98-2.21; p=0.06). Screening FH+ men also showed a trend towards decreased PCa specific mortality with a hazard ratio of 0.49 (95% CI 0.22-1.1; p=0.08) and also a reduced time to death from PCa (log-rank; p=0.05).
Caucasian men with a FH of PCa are at increased risk of being diagnosed and subsequently dying from prostate cancer. Yearly digital rectal exams and PSA testing may reduce prostate cancer death in these individuals.
Copyright © 2014 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.
Family History; PSA; Prostate Cancer; Screening
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