A large-scale study, published in European Urology, found that men with a BRCA2 gene mutation not only have a significantly higher risk of prostate cancer but also tend to develop the disease earlier with more aggressive tumours. The researchers are now calling for Europe-wide annual screening for all men over 40 carrying the BRCA2 gene mutation.
'For women who undergo genetic testing, options are available to them if they carry a BRCA fault, including preventative surgery and increased screening,' said study leader Professor Rosalind Eeles from the Institute of Cancer Research in London. '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,' she added.
The three-year 'IMPACT' study looked at around 1400 men from across 65 centres in 20 different countries. The researchers compared the efficiency of yearly PSA (prostate specific antigen) testing to detect prostate cancer in those that have the BRCA2 mutation and those that do not. The researchers found that men carrying the BRCA2 mutation were almost twice as likely to be diagnosed with prostate cancer compared to those without. Carriers were also diagnosed at a younger age (61 compared to 64 in non-carriers) and 77 percent had more aggressive tumours compared with 40 percent of non-carriers, suggesting that men with a BRCA2 mutation could benefit from regular PSA testing.
'Understanding more about people at higher risk of prostate cancer is an incredibly important area of research,' said Professor Charles Swanton, chief clinician at Cancer Research UK, which funded the study. '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.'
The BRCA2 mutation – carried by around one in 300 white men – is also associated with a 50 to 80 percent risk of developing breast and ovarian cancer in women.
Sarah Coghlan, of the Movember men's health charity, told the Daily Mail: 'Men need to be aware that having a family history of breast or ovarian cancer, could mean they are at greater risk of developing prostate cancer. They need to be asking questions about their own family history and share their own more comprehensively with immediate family members.'