Family history facilitates the early diagnosis of prostate carcinoma.

Abstract

Although all men age >50 years are at an increased risk for the development of prostate carcinoma, 2 major factors increase this risk: family history and race. This article outlines the influence of family history on the risk of prostate carcinoma and current understanding of factors that increase this risk. Published studies investigating the familial and hereditary link to prostate carcinoma are reviewed. The results of an investigation into the mendelian inheritance of prostate carcinoma are discussed as well as the relation between hereditary cancer syndromes such as breast and ovarian carcinoma and prostate carcinoma. A positive family history of prostate carcinoma increases the relative risk of prostate carcinoma in male first-degree relatives approximately twofold. Prostate carcinoma is inherited as an autosomal dominant trait. The relative risk of prostate carcinoma increases with multiple affected relatives. Hereditary prostate carcinoma is estimated to be associated with 43% of men in whom the diagnosis of prostate carcinoma is made at age <55 years, 34% of men in whom the diagnosis is made at age <70 years, and only 9% of men diagnosed before age 85 years. Hereditary prostate carcinoma should be suspected in families with an early age at onset of the disease and/or multiple affected family members. Because hereditary prostate carcinoma is characterized by an early age at onset, first-degree relatives in high risk families should begin screening before age 50 years.