Further follow-up needed to assess benefit of PSA screening in male BRCA1 mutation carriers
WEDNESDAY, Nov. 27, 2019 (HealthDay News) — Systematic prostate-specific antigen (PSA) screening is advised for men who are carriers of the BRCA2 mutation, which is associated with a higher incidence of prostate cancer, younger age at diagnosis, and clinically significant tumors, according to the interim results of a study published in the December issue of European Urology.
Elizabeth C. Page, from the Institute of Cancer Research in London, and colleagues evaluated the utility of targeted prostate cancer screening using PSA in men with pathogenic, germline BRCA1/2 mutations and controls (919 BRCA1 carriers, 709 BRCA1 noncarriers, 902 BRCA2 carriers, and 497 BRCA2 noncarriers).
The researchers found that after three years of screening, 527 men had PSA >3.0 ng/mL, 357 biopsies were performed, and 112 prostate cancer cases were diagnosed (31 BRCA1 carriers, 19 BRCA1 noncarriers, 47 BRCA2 carriers, and 15 BRCA2 noncarriers). In BRCA2 carriers, the cancer incidence rate was higher than in noncarriers (19.4 versus 12.0 per 1,000 person years). BRCA2 carriers were diagnosed at a younger age (61 versus 64 years) and were more likely to have clinically significant disease compared with BRCA2 noncarriers (77 versus 40 percent). There were no differences in age or tumor characteristics between BRCA1 carriers and BRCA1 noncarriers. Compared with PSA alone (area under the curve, 0.65), the 4 kallikrein marker model discriminated better (area under the curve, 0.73) for clinically significant cancer at biopsy.
“We recommend that male BRCA2 carriers are offered systematic PSA screening,” the authors write.
Several authors disclosed financial ties to the diagnostics industry.
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