Leading Scientists Advocate for Annual Prostate Cancer Screening for Men with BRCA1 and BRCA2 Gene Mutations

Strategic Insights -

Men with BRCA1 and BRCA2 gene mutations face a significantly higher risk of aggressive prostate cancer, according to a new study published in the European Society for Medical Oncology (ESMO) Congress in Berlin. The study, funded by Cancer Research UK, the Institute of Cancer Research (ICR), and others, found that men with BRCA1 genetic fault were more than three times as likely to have aggressive prostate cancers compared with people without the fault. The ICR team is urging regulatory bodies to update current guidance to offer annual prostate cancer screening to men with BRCA1 and BRCA2 mutations from 40 years old.

Key Takeaways:

  • The study assessed the potential benefits of PSA testing in men with BRCA1 and BRCA2 mutations at 65 centres in 20 different countries around the world.
  • Men with BRCA1 genetic fault were more than three times as likely to have aggressive prostate cancers compared with people without the fault.
  • The study found there was no difference in age of diagnosis, or the risk of developing prostate cancer, for BRCA1 carriers compared with non-carriers.
  • The risk of prostate cancer in BRCA2 carriers being more than double than in non-carriers, from 1.4% to 3.1%.
  • The average age of diagnosis is 60 for carriers of the BRCA1 and BRCA2 genes.
  • The ICR team is calling for guidance to be updated so that both BRCA1 and BRCA2 carriers can receive annual PSA testing.
  • The study offered annual PSA testing to more than 3,000 men for five years, with scientists and charities divided on the issue of widespread population screening.
  • Evidence suggests PSA levels can rise for many reasons, including simple infections, and 75% of people with a raised PSA do not have prostate cancer.
  • A raised PSA level can mean men are referred for unnecessary biopsies or MRI, or treated for tumours that may never cause harm.
  • The PSA test can also miss aggressive cancer, with evidence suggesting around 15% of people with a normal result may actually have prostate cancer.
  • Prostate Cancer UK has funded Professor Eeles' work for many years and is now one of the lead researchers on their £42m Transform screening trial.

Statistics:

  • Men with BRCA2 mutations have a higher chance of developing prostate cancer at a younger age and in a more aggressive form: between 21 and 35 of 100 men with a BRCA2 variant will develop prostate cancer before the age of 80.
  • The risk of prostate cancer in BRCA2 carriers being more than double than in non-carriers, from 1.4% to 3.1%.
  • The average age of diagnosis is 60 for carriers of the BRCA1 and BRCA2 genes.
  • The study offered annual PSA testing to more than 3,000 men for five years.
  • Evidence suggests PSA levels can rise for many reasons, including simple infections, and 75% of people with a raised PSA do not have prostate cancer.
  • A raised PSA level can mean men are referred for unnecessary biopsies or MRI, or treated for tumours that may never cause harm.

Sources:

  • The European Society for Medical Oncology (ESMO) Congress in Berlin
  • Cancer Research UK
  • The Institute of Cancer Research (ICR)
  • Prostate Cancer UK
  • "Men with BRCA1 and BRCA2 gene mutations 'should be given annual prostate cancer checks'"