Prostate Cancer
Genetics
As many as 9 percent of Caucasian males and 10 percent of African-American males
in the US will develop prostate cancer in their lifetime.
The majority of cases of prostate cancer are sporadic, which means that one person
in the family developed prostate cancer by chance at a typical age of onset. In
these cases, other male relatives have little to no increased risk of developing
prostate cancer.
About 15 percent of prostate cancers are familial, which means there is a father
or brother also affected, at typical ages of onset. Familial cancers may be due
to a combination of genes and shared lifestyle factors or environmental exposures
(multifactorial inheritance). On the other hand, some of these histories can represent
a chance occurrence of sporadic cancers. A familial history may also arise due to
a single gene mutation (hereditary cancer) that has reduced penetrance (a mutation
associated with lower cancer risks and later onset of cancer). In general, with
familial cancer, close relatives have a modestly increased risk of developing the
cancer in question. The chance that genetic testing will be beneficial in further
assessing cancer risks is usually small. Studies have found a trend of an increased
chance to develop prostate cancer, with an increasing number of family members.
In other words, the more relatives you have with prostate cancer, the higher the
risk:
Potential risk of familial prostate cancer
|
Number of relatives with prostate cancer |
Prostate cancer risk |
|
1 first-degree relative (father, brother, or son) |
2 to 3 times higher (than the average population risk) |
|
2 first-degree relatives (father, brother, or son) |
5 times higher (than the average population risk) |
|
1 first-degree relative and 1 second-degree relative |
8 times higher (than the average population risk) |
|
3 first-degree relatives (father, brother, or son) |
11 times higher (than the average population risk) |
Approximately 5 percent to 10 percent of all prostate cancers and 45 percent of
cases in men younger than age 55 can be attributed to a cancer susceptibility gene
that is inherited as a dominant trait (from parent to child). Genetic heterogeneity
has been observed with prostate cancer, which means that more than one gene has
been implicated in its cause, including genes on chromosomes #1, 7, 8, 10, 11, 17,
and X. At present, there are many continuing research studies to determine the specific
mechanism of how gene mutations contribute to an increased susceptibility for prostate
cancer; clinical testing is not available at the time of this writing.