Screening white men with a family history of prostate cancer appears to be associated with a decrease in prostate cancer-specific mortality, according to a study published in The Journal of Urology.
Michael A. Liss, M.D., from the University of California-San Diego Health System, and colleagues used data from the PLCO (Prostate, Lung, Colorectal and Ovarian) cancer screening trial to compare prostate cancer-specific mortality in the screening and usual care arms of men with and without family history of prostate cancer.
Data were included for 65,179 white subjects, of whom 11.2 percent were diagnosed with prostate cancer and 7.4 percent had a family history of prostate cancer.
The researchers found that positive family history correlated with significantly increased incidence of prostate cancer (16.9 versus 10.8 percent; P < 0.01) and prostate cancer-specific mortality (0.56 versus 0.37 percent; P < 0.01), with a trend toward significance after multivariate adjustment (hazard ratio, 1.47; 95 percent confidence interval, 0.98 to 2.21; P = 0.06).
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In men with a positive family history, screening correlated with a trend toward decreased prostate cancer-specific mortality (hazard ratio, 0.49; 95 percent confidence interval, 0.22 to 1.1; P = 0.08) and with decreased time to prostate cancer death (log rank P = 0.05).
“With these promising data it may be more prudent to focus screening efforts on high-risk groups such as those with a positive family history, and possibly even black men and others with a genetic predisposition rather than abandoning them in general as suggested by the U.S. Preventive Services Task Force,” the authors write.
One author disclosed financial ties to the pharmaceutical and medical device industries.