Prostate cancer genetic risk assessment could help guide screening decisions

Scientists have come up with a new tool which might help to predict a man's genetic risk of developing prostate cancer.

The test can help predict which men would benefit from screening for the disease, researchers said.

At present men over the age of 50 can have a prostate specific antigen (PSA) test which could indicate prostate problems, including prostate cancer.

But the test is not routinely given to all men as it may lead to over-diagnosis and over-treatment of some patients who may not have needed intense cancer therapy.

Now experts have come up with a new tool which they say may help guide decisions about whether and when to screen for prostate cancer.

The new study, published in The BMJ, saw researchers develop and test a genetic tool to predict age of onset of aggressive prostate cancer and to guide decisions of who to screen and at what age.

They analysed over 200,000 gene variants - known as single nucleotide polymorphisms or SNP - from 31,747 European men who did and did not have prostate cancer.

Scientists, led by researchers from the Centre for Multimodal Imaging and Genetics in California, in the US, identified 54 associated with an increased risk of prostate cancer.

They then used these to develop a genetic risk score which could help predict the age of diagnosis of aggressive prostate cancer.

• In 2014 there were 46,690 new cases of prostate cancer in the UK

• In the same year there were 11,287 deaths from the disease

• 84% of men survive prostate cancer for 10 or more years

The tool was then tested on 6,411 men. Researchers found that men in the top 2% of the score had an almost three-fold greater relative risk for aggressive prostate cancer compared with men with average risk.

The authors concluded: "The score is a relatively inexpensive assessment of an individual man's age specific risk and provides objective information on whether a given patient might benefit from PSA screening."

They added: "As the score is representative of a man's fixed genetic risk, it can be calculated once, long before onset of prostate cancer, and substantially inform the decision of whether he should undergo prostate cancer screening."

Dr Matthew Hobbs, deputy director of research at Prostate Cancer UK, said: "Although the results are interesting, to make a real difference the test would have to be able to identify men at higher risk of prostate cancer before the age of 50 so that they know to request the PSA test early, or men at no risk at all after the age of 50, so that they can forego the test altogether. At the moment, the findings do not indicate that this is possible."