Survival outcomes in men with a positive family history of prostate cancer: a registry based study

Abstract

Background To investigate the correlation between family history of prostate cancer (PCa) and survival (overall and cancer specific) in patients undergoing treatment for PCa. Methods ine thousand four hundred fifty-nine patients with PCa were extracted from the South Australian Prostate Cancer Clinical Outcomes Collaborative (SA-PCCOC) database. Diagnosis occurred after 1998 and treatment before 2014. Cox proportional-hazards modeling was used to assess the effect of family history on overall survival after adjustment for confounders (age at diagnosis, NCCN risk category and year of treatment), and with stratification by primary treatment group. Competing risks regression modelling was used to assess PCa specific mortality. Results Men with a positive family history of PCa appear to have a lower Gleason score at the time of diagnosis (50% with Gleason < 7, compared to 39% in those without family history) and be diagnosed at a lower age (64 vs 69). Men with a positive family history of PCa appear to have better overall survival outcomes (p < 0.001, log rank test). In analysis adjusting for age at diagnosis, NCCN risk category and year of treatment, family history remained a significant factor when modelling overall survival (HR 0.72 95% CI 0.55–0.95, p = 0.021). There were no significant differences in treatment subgroups of radical prostatectomy (p = 0.7) and radiotherapy (0.054). Conclusion Men with a positive family history of PCa appear to have better overall survival outcomes. This better survival may represent lead time bias and early initiation of PSA screening. Family history of PCa was not associated with different survival outcomes in men who were treated with either radical prostatectomy or radiotherapy.

Neighborhood deprivation and risk of mortality among men with prostate cancer: Findings from a long‐term follow‐up study

“…In addition, deprived neighborhoods often have fewer medical facilities, lower quality education, poorer patient–provider relationships that may lead to less screening for PCa, increasing the risk of fatal cancer 5–7 . Many biological and behavioral risk factors have been studied in relation to PCa mortality 8–20 . However, conflicting results on the association between PCa mortality and family history of PCa, socioeconomic status, smoking, obesity, and low social support have been reported 10,15,16,18,20–26 .…”

The association between family history of prostate cancer and development of prostate cancer among Korean population

“…Third, since the pathologic findings are not included in the KoGES data, we were unable to assess whether FH was associated with pathologic outcomes of PCa. Although previous studies reported that FH in PCa patients were associated with low-risk disease or better survival outcome, [ 26 , 27 ] this also needs to be validated in the Korean population. And lastly, the sample size of PCa patients was small; the number in the patient group was only 0.1% of the number in the control group (100 vs 69,593).…”

Clinicopathological Characteristics of Prostate Cancer in Tlemcen (Northwestern Algeria)

“…Two large studies, both in the pre-prostate-specific antigen (PSA) era, considered family history as a predictor of fatal prostate cancer (19,20); nevertheless, studies of the PSA era have failed to confirm such a negative impact of family history on prostate cancer prognosis (21)(22)(23)(24). More recent studies demonstrated that men with a positive family history of prostate cancer appear to have better overall survival outcomes (25)(26)(27). This could be explained by the fact that men with a positive family history for prostate cancer are increasingly unlikely to manifest aggressive tumors; alternatively, because they are more aware of their own potential risk, they may seek an earlier detection, be diagnosed with earlier-stage cancer and, thus, have favorable tumor prognosis.…”