Journal: International journal of cancer
This population‑based Swedish study evaluated how a father’s prostate cancer characteristics affect his son’s prostate cancer risk, particularly for high‑risk disease.
Design and cohort:
- • Men in the Prostate Cancer data Base Sweden whose fathers were diagnosed with prostate cancer between 1998–2005 were identified (n = 25,287 sons).
- • Standardized incidence ratios (SIRs) were calculated by comparing observed prostate cancer cases in these sons with expected cases in the general Swedish male population.
Key findings:
- • Overall, sons of affected fathers had a substantially increased risk of prostate cancer.
- • Paternal age at diagnosis was important:
- • Fathers diagnosed <65 years: sons’ SIR for any prostate cancer was 4.3 (95% CI 3.8–5.0).
- • Fathers diagnosed ≥70 years: sons’ SIR was 2.3 (95% CI 1.9–2.8).
- • High‑grade disease in sons was associated with both younger paternal age at diagnosis and high‑grade disease in the father:
- • Sons of fathers diagnosed <65 years had higher risk of Gleason ≥8 cancers (SIR 2.3; 95% CI 1.1–4.1) vs sons of fathers diagnosed ≥70 years (SIR 1.2; 95% CI 0.4–2.6).
- • Having a father with Gleason ≥8 was specifically associated with higher risk of Gleason ≥8 in the son (SIR 2.6; 95% CI 1.1–5.1).
Clinical implication:
- • Family history counseling for prostate cancer should account not only for presence/absence of prostate cancer in first‑degree relatives, but also for age at diagnosis and tumor grade in the affected father.
- • These data support more individualized PSA testing and diagnostic strategies in men with early‑onset and/or high‑grade prostate cancer in a first‑degree relative.