Men with the BRCA2 gene fault have a higher risk of developing prostate cancer and would benefit from prostate specific antigen (PSA) testing to help detect the disease earlier, according to new research.
Although previous studies have shown that PSA is not a suitable test for screening for prostate cancer in the general population, this new study published today (17 September 2019) found that PSA tests were more likely to pick out more serious forms of prostate cancer in men who carry the BRCA2 gene fault.
Researchers at The Institute of Cancer Research, London, studied about 1400 men and compared those who do not carry the BRCA2 gene fault with those who do.
Writing in the latest edition of European Urology, the team describe how the men were offered a yearly PSA test. If they needed it, the participants were offered a biopsy to confirm their disease and treated. If no action was required, they were asked to return the following year.
They found that men with the BRCA2 gene fault were almost twice as likely to be diagnosed with prostate cancer than non-carriers. They were also diagnosed with more serious tumours, with 77% of men having clinically significant disease compared with 40% of non-carriers.
However, the study, funded by Cancer Research UK, did not look at whether or not PSA testing reduced the number of men who died from prostate cancer, which is needed to prove the value of screening in any group.
Study leader, Rosalind Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London, and Consultant Clinical Oncologist at The Royal Marsden NHS Foundation Trust, said: “For women who undergo genetic testing, options are available to them if they carry a BRCA fault, including preventative surgery and increased screening.
“But there’s no prevention pathway in place if men decide to find out if they’re a carrier. Which is why our research is so important.
“Men may get tested for the BRCA fault due to a family history of breast cancer, as they could pass the gene onto their children, which is especially significant if they have daughters. And our research offers this group of men more insight into their own health.
“Based on our results, we would recommend offering men who carry a fault in the BRCA2 regular PSA tests, so that they can be diagnosed and treated earlier.”
Professor Charles Swanton, Cancer Research UK’s chief clinician, added: “Previous studies have shown that PSA is not a suitable test for screening for prostate cancer in the general population. But we still need to understand whether PSA testing would reduce deaths from the disease in any high-risk groups before we make any recommendation.”
Page et al. Interim results from the IMPACT study: evidence for PSA screening in BRCA2 mutation carriers. European Urology 16 September 2019; doi:10.1016/j.eururo.2019.08.019
Leave a Reply