Men With BRCA Mutations at Increased Risk of Prostate Cancer, Study Confirms

By Reuters Staff

September 17, 2019

NEW YORK (Reuters Health) - Males who carry BRCA1 or BRCA2 mutations are at increased risk of prostate cancer (PC), a new prospective study confirms.

BRCA1/2 mutations have been associated with a two- to six-fold increased risk of PC in men, but most estimates have been based on retrospective studies, Tommy Nyberg of the University of Cambridge, in the U.K., and colleagues note in European Urology, online September 6.

The authors followed 376 male BRCA1 carriers and 447 male BRCA2 carriers treated at clinical-genetics centers in the U.K. and Ireland for a median of 5.9 and 5.3 years, respectively.

During follow-up, 16 BRCA1 and 26 BRCA2 carriers were diagnosed with PC. The standardized incidence ratio (SIR) was 4.45 for BRCA2 carriers, who had an absolute risk of PC of 27% at age 75 and 60% at age 85.

BRCA1 carriers' overall SIR was 2.35, and 3.57 for BRCA1 carriers under 65.

For BRCA2 carriers, a family history of PC was associated with significantly increased risk, while mutations in the ovarian cancer cluster region (OCCR) of the gene were associated with lower PC risk compared with mutations outside the OCCR.

BRCA2 was also more strongly associated with cancers with a Gleason score of at least 7 than with cancers with Gleason scores of 6 or lower.

BRCA2 carriers were at significantly increased risk of dying from PC (standardized mortality ratio, 3.85), while BRCA1 mutations were not significantly associated with PC mortality.

"The results substantiate previous reports from retrospective studies of a strong association between BRCA2 mutations and PCa risk, and give some support for a similar but weaker association for mutations in the BRCA1 gene, particularly at younger ages," Nyberg and his team write.

They conclude: "The results will be informative in the counselling of men who carry BRCA1 or BRCA2 mutations."

SOURCE: https://bit.ly/2kL3BX1

Eur Urol 2019.

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