Strong family history of prostate cancer linked to better survival

Being aware of a strong family history of prostate cancer is linked to an increased chance of surviving the disease, new research suggests.

The study showed that men diagnosed with prostate cancer who reported a strong family history had better survival rates than those with a weaker family history.

Researchers at The Institute of Cancer Research, London, and The Royal Marsden NHS Foundation Trust believe these men are surviving longer because of their increased awareness of prostate cancer—which can lead to earlier diagnosis and treatment.

The observational study highlights the importance of assessing men for their risk of prostate cancer and raising awareness of the role played by family history.

Up to a fifth less likely to die from the disease

Men with prostate cancer who also had relatives affected by the disease—or by other cancers with an inherited element like breast, ovarian or bowel cancer—were up to a fifth less likely to die from prostate cancer or any cause compared with those with no family history of cancer. And the researchers found that the impact on survival was greater, the stronger the family history that patients reported.

The researchers analyzed the type and timing of patients’ cancer diagnoses. They concluded that the higher survival rates among men with a strong family history were likely to be a result of increased awareness, and its benefits for earlier diagnosis and treatment—rather than a difference in the severity of the cancers.

Looking at data for more than 16,000 men

The United Kingdom Genetic Prostate Cancer Study, published in the journal European Urology, looked at survival data for 16,340 men diagnosed with prostate cancer. It involved multiple centers across the U.K. and has been collecting data since 1992.

If a man has a father or brother with prostate cancer, his risk of also developing prostate cancer is significantly higher than the average person. However, what remained unclear until now was whether having a family history of prostate cancer affects the outcomes of the disease and people’s likelihood to survive.

The size of this study, coupled with extensive detailed clinical information and follow-up, allowed researchers to break down how the number, degree and age of patients’ affected relatives were associated with survival outcomes.

Researchers found that the risk of death from prostate cancer or any cause was 15% lower for men with one affected first- or second-degree relative than in those without any family history of prostate cancer. Having two or more affected relatives was associated with a 20% lower risk of death.

Findings could be explained by an ‘awareness’ effect

The ICR and Royal Marsden team also found that having a family history of prostate cancer was linked to a younger age at diagnosis—suggesting those with a family history of prostate cancer were more likely to have the disease diagnosed earlier.

The researchers cautioned that the study had observed correlations rather than directly proving the effect of awareness and screening. Patients involved in the study were mostly of European ancestry, and it lacked data on important epidemiological risk factors for death, such as smoking and co-morbidities.

Despite these limitations, the researchers are confident that the findings can be explained by an ‘awareness’ effect, and provide further evidence of the benefits of programs to identify men at high risk and potentially screen for disease.

‘Men are much better off knowing about previous cancers in their family’

Study leader Professor Ros Eeles, Professor of Oncogenetics at The Institute of Cancer Research, London, and Consultant in Clinical Oncology and Cancer Genetics at The Royal Marsden NHS Foundation Trust, said, “Knowledge really is power. Our study suggests that men with prostate cancer are much better off knowing about previous cancers in their family.

“We wanted to understand how a family history of prostate cancer affects survival in men diagnosed with the disease. We categorized more than 16,000 patients according to the strength of their family history, and found that the stronger their family history, the better they did in terms of overall survival.

“After looking at the type and timing of patients’ diagnoses, we have concluded that this is likely to be explained by an ‘awareness’ effect, which seems to lead to earlier diagnosis and, as a consequence, better survival.”

‘The research highlights the importance of awareness’

Professor Kristian Helin, Chief Executive of The Institute of Cancer Research, London, said, “These findings suggest that being aware of your personal risk of prostate cancer can lead to earlier diagnosis and treatment, and that this translates into improved survival.

“The research highlights the importance of awareness and screening programs for men with prostate cancer, and is an endorsement of the work we are doing to identify those at the highest inherited risk. As the largest epidemiological study of its kind, this is likely to have implications for future awareness programs for prostate cancer as we seek to ensure all men with the disease are diagnosed as early as possible.”

More information:
Mark N. Brook et al, Family History of Prostate Cancer and Survival Outcomes in the UK Genetic Prostate Cancer Study, European Urology (2022). DOI: 10.1016/j.eururo.2022.11.019

Journal information:
European Urology

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