Men Over 40 With BRCA2 Mutations Must Get Prostate Cancer Screening, Experts Say
Forbes, November 5, 2019,
Written by Victoria Forstar, healthcare contributorResearchers from the U.K. and the U.S. have called for immediate action to recommend screening for prostate cancer for men with BRCA2 mutations over the age of 40 after presenting the results of a new study today at the National Cancer Research Institute annual meeting in Glasgow.
BRCA mutations are most commonly known to greatly increase the risk of breast and ovarian cancer in women with the disease, but also increase the risk of several types of cancer in men, including breast and prostate. Earlier this year, scientists also showed that BRCA2 mutations also likely increase the chance of a type of childhood cancer called non-Hodgkin lymphoma.
The new research looked at almost 3,000 men aged 40-69, with just over half carrying inherited mutations in either BRCA1 or BRCA2 and the others healthy controls. The men were screened with a common test for prostate cancer called the PSA (prostate-specific antigen) test.
The study found that the incidence of prostate cancer in men with BRCA2 mutations was significantly higher than in men with no BRCA mutations and that BRCA2 carriers were typically diagnosed when younger and had more substantial disease. There were no differences observed in men who carried BRCA1 mutations, compared to healthy controls.
“Our research shows very clearly that men with the BRCA2 gene fault are at increased risk of aggressive prostate cancer and that regular PSA testing could go some way to improving early diagnosis and treatment,” said Ros Eeles, Professor of oncogenetics at the Institute for Cancer Research in London and leader of the new study.
The PSA test is highly controversial with previous studies showing issues with false diagnoses based on incorrect results from the test. Another issue is over-diagnosis, which is where very minor or harmless tumors are picked up and consequently treated with sometimes significant side-effects, but likely would have been harmless if left alone.
The U.S. preventative services task force on cancer recommends that PSA testing for prostate cancer in men aged 55 to 69 is an individual choice and does not recommend the test for men over 70. The researchers on the current study also do not believe that PSA testing is suitable for diagnosis of prostate cancer in people without BRCA2 mutations.
“Every man over the age of 40 who carries a mutation in the BRCA2 gene should be offered an annual PSA test, as a way of giving men more control over their own health by identifying prostate cancer which is more aggressive and needs treatment,” said Eeles.