Family History Of Prostate Cancer Research Articles

The Use of Glucagon-like Peptide-1 Receptor Agonists in Patients with Type 2 Diabetes Mellitus Does Not Increase the Risk of Pancreatic Cancer: A U.S.-Based Cohort Study.

GLP-1 RAs are widely used for T2DM treatment due to their cardiorenal and metabolic benefits. This study examines the risk of pancreatic cancer with GLP-1 RA use in patients with T2DM. We analyzed TriNetX's deidentified research database using the U.S. Collaborative Network comprising 62 healthcare organizations across the U.S.A. Patients with T2DM were split into two cohorts: one receiving GLP-1 RAs, and one not receiving GLP-1 RAs. We excluded patients with known risk factors for pancreatic cancer, including pancreatic cysts, a personal or family history of BRCA1, BRCA2, CDKN2A, KRAS, MEN1, MLH1, MSH2, NOTCH1, PALB2, PMS2, and PRSS1S genes, family history of pancreatic cancer, and VHL syndrome. Using a 1:1 propensity score-matching model based on baseline characteristics and comorbidities, we created comparable cohorts. We then compared the rate of pancreatic cancer between the two cohorts at a 7-year interval. Out of 7,146,015 identified patients with T2DM, 10.3% were on a GLP-1 RA and 89.7% were not. Post-PSM, 721,110 patients were in each group. Patients on GLP-1 RAs had a 0.1% risk compared to a 0.2% risk of pancreatic cancer in the 7-year timeframe. The use of GLP-1 RAs in patients with type 2 diabetes mellitus (T2DM) does not appear to substantially elevate the risk of pancreatic cancer; in fact, it may potentially exert a protective effect.

An early-onset specific polygenic risk score optimizes age-based risk estimate and stratification of prostate cancer: population-based cohort study

BackgroundEarly-onset prostate cancer (EOPC, ≤ 55 years) has a unique clinical entity harboring high genetic risk, but the majority of EOPC patients still substantial opportunity to be early-detected thus suffering an unfavorable prognosis. A refined understanding of age-based polygenic risk score (PRS) for prostate cancer (PCa) would be essential for personalized risk stratification.MethodsWe included 167,517 male participants [4882 cases including 205 EOPC and 4677 late-onset PCa (LOPC)] from UK Biobank. A General-, an EOPC- and an LOPC-PRS were derived from age-specific genome-wide association studies. Weighted Cox proportional hazard models were applied to estimate the risk of PCa associated with PRSs. The discriminatory capability of PRSs were validated using time-dependent receiver operating characteristic (ROC) curves with additional 4238 males from PLCO and TCGA. Phenome-wide association studies underlying Mendelian Randomization were conducted to discover EOPC linking phenotypes.ResultsThe 269-PRS calculated via well-established risk variants was more strongly associated with risk of EOPC [hazard ratio (HR) = 2.35, 95% confidence interval (CI) 1.99–2.78] than LOPC (HR = 1.95, 95% CI 1.89–2.01; I2 = 79%). EOPC-PRS was dramatically related to EOPC risk (HR = 4.70, 95% CI 3.98–5.54) but not to LOPC (HR = 0.98, 95% CI 0.96–1.01), while LOPC-PRS had similar risk estimates for EOPC and LOPC (I2 = 0%). Particularly, EOPC-PRS performed optimal discriminatory capability for EOPC (area under the ROC = 0.613). Among the phenomic factors to PCa deposited in the platform of ProAP (Prostate cancerAge-basedPheWAS; https://mulongdu.shinyapps.io/proap), EOPC was preferentially associated with PCa family history while LOPC was prone to environmental and lifestyles exposures.ConclusionsThis study comprehensively profiled the distinct genetic and phenotypic architecture of EOPC. The EOPC-PRS may optimize risk estimate of PCa in young males, particularly those without family history, thus providing guidance for precision population stratification.

Clinical features of prostate cancer by polygenic risk score.

Genome-wide association studies have identified more than 290 single nucleotide variants (SNVs) associated with prostate cancer. These SNVs can be combined to generate a Polygenic Risk Score (PRS), which estimates an individual's risk to develop prostate cancer. Identifying individuals at higher risk for prostate cancer using PRS could allow for personalized screening recommendations, improve current screening tools, and potentially result in improved survival rates, but more research is needed before incorporating them into clinical use. Our study aimed to investigate associations between PRS and clinical factors in affected individuals, including age of diagnosis, metastases, histology, International Society of Urological Pathology (ISUP) Grade Group (GG) and family history of prostate cancer, while taking into account germline genetic testing in known prostate cancer related genes. To evaluate the relationship between these clinical factors and PRS, a quantitative retrospective chart review of 250 individuals of European ancestry diagnosed with prostate cancer who received genetic counseling services at The Ohio State University's Genitourinary Cancer Genetics Clinic and a 72-SNV PRS through Ambry Genetics, was performed. We found significant associations between higher PRS and younger age of diagnosis (p = 0.002), lower frequency of metastases (p = 0.006), and having a first-degree relative diagnosed with prostate cancer (p = 0.024). We did not observe significant associations between PRS and ISUP GG, histology or a having a second-degree relative with prostate cancer. These findings provide insights into features associated with higher PRS, but larger multi-ancestral studies using PRS that are informative across populations are needed to understand its clinical utility.

Fine particulate matter, noise pollution, and greenspace and prostate cancer risk in the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial Cohort.

Greenspace is hypothesized as being protective against cancer, whereas noise pollution and fine particulate matter (<2.5 µm in diameter, PM2.5) are both potential risk factors. Findings from recent studies of greenspace and PM2.5 with prostate cancer are not conclusive and the association between noise exposure and cancer has not been evaluated in a U.S. We assessed PM2.5, noise, and greenspace exposure using spatiotemporal models and satellite-based estimates at enrollment addresses for N=43,184 male participants of the prospective Prostate, Lung, Colorectal, and Ovarian Cancer (PLCO) Screening Trial cohort (enrolled 1994-2001). We used Cox regression models adjusted for age, race and ethnicity, study center, family history of prostate cancer, and Area Deprivation Index to estimate associations between ambient PM2.5 (µg/m3), greenspace (index range from -1 to 1), and noise pollution (loudest 10% of total existing sound, decibels) and incident prostate cancer risk through December 2017. A total of 6,327 cases of prostate cancer were diagnosed among male participants during follow-up. PM2.5 and noise exposures were moderately positively correlated (Spearman's rho=0.46), and PM2.5 and greenspace were not correlated (ρ=0.10); greenspace and noise were inversely correlated (ρ=-0.32). In single-pollutant and multipollutant models mutually adjusted for co-exposures, we found no associations with prostate cancer risk. We did not find evidence that PM2.5, greenspace, and noise pollution were associated with prostate cancer risk in this large, geographically spread cohort. This study contributes to a small body of existing literature investigating these biologically plausible associations.

Impact of Family History and Germline Genetic Risk Single Nucleotide Polymorphisms on Long-Term Outcomes of Favorable-Risk Prostate Cancer.

Family history and germline genetic risk single nucleotide polymorphisms (SNPs) have been separately shown to stratify lifetime risk of prostate cancer. Here, we evaluate the combined prognostic value of family history of prostate and other related cancers and germline risk SNPs among patients with favorable-risk prostate cancer. A total of 1367 participants from the prospective Health Professionals Follow-up Study diagnosed with low- or favorable intermediate-risk prostate cancer from 1986 to 2017 underwent genome-wide SNP genotyping. Multivariable Cox regression was used to estimate the association between family history, specific germline risk variants, and a 269 SNP polygenic risk score with prostate cancer‒specific death. Family history of prostate, breast, and/or pancreatic cancer was observed in 489 (36%) participants. With median follow-up from diagnosis of 14.9 years, participants with favorable-risk prostate cancer with a positive family history had a significantly higher risk of prostate cancer‒specific death (HR 1.95, 95% CI 1.15-3.32, P = .014) compared to those without any family history. The rs2735839 (19q13) risk allele was associated with prostate cancer‒specific death (HR 1.81 per risk allele, 95% CI 1.04-3.17, P = .037), whereas the polygenic risk score was not. Combined family history and rs2735839 risk allele were each associated with an additive risk of prostate cancer‒specific death (HR 1.78 per risk factor, 95% CI 1.25-2.53, P = .001). Family history of prostate, breast, or pancreatic cancer and/or a 19q13 germline risk allele are associated with an elevated risk of prostate cancer‒specific death among favorable-risk patients. These findings have implications for how family history and germline genetic risk SNPs should be factored into clinical decision-making around favorable-risk prostate cancer.

The BRCA mutation spectrum among breast and ovarian cancers in India: highlighting the need to screen BRCA1 185delAG among South Indians.

Mutations in BRCA1 and BRCA2 significantly elevate the risk of developing breast and ovarian cancer. Limited data exists regarding the prevalence ofBRCA mutations, and optimal, cost-effective testing strategies in developing countries like India. This study aimed to evaluate the utility of a Next Generation Sequencing (NGS) panel for BRCA1/2 mutation testing among women diagnosed with, or at risk of developing hereditary breast and ovarian cancers. We also aimed to identify population specific BRCA1/2 mutation hotspots, to enable the development of more affordable testing strategies. We identified 921 patients with breast and ovarian cancer who underwent mutation testing. The target enrichment wasfollowed by targeted NGS in 772 patients and an allele-specific PCR (ASPCR) based genotyping for BRCA1:c.68_69delAG (or 185delAG), was carried out in 149 patients. We identified 188 (20.4%) patients with BRCA1/2 variants: 118 (62.8%) withpathogenic/likely pathogenic and 70 (37.2%)with VUS. The 185delAG was identified as a recurrent mutation in the Southern Indian population, accounting for 24.6% of the pathogenic variants. In addition, a family history of breast, ovary, pancreas, or prostate (BOPP) cancer was found to be associated with an increased risk of identifying a deleterious BRCA1/2 variant [OR = 2.11 (95% CI 1.45-3.07) p ≤ 0.001]. These results suggest that TargetedNGS is a sensitive and specific strategy for BRCA testing. For Southern Indian patients, a two-tiered approach can be considered: Initial screening with ASPCR for BRCA1185delAG followed by NGS for those testing negative. Expanding the gene panel and identifying other population-specific mutation hot spots is a promising area with potential for improvements in testing and treatment strategies.

Prostate Cancer Screening Behaviors and Health Beliefs Regarding Prostate Cancer Screening of Individuals Over 50 Years of Age: A Descriptive, Cross-Sectional Study

Purpose: This descriptive cross-sectional study was conducted to assess the prostate cancer screening behaviors and health beliefs related to prostate cancer screening among individuals aged 50 and over. &#x0D; Material and Methods: The study sample consisted of 72 men aged 50 and over receiving treatment at the orthopedics and traumatology clinic of a university hospital. Data were collected using a "Personal Information Form" and the "Prostate Cancer Screening Health Belief Model Scale." &#x0D; Results: The mean age of the participants in the study was 61.59±8.51 years. It was found that 22.2% of the participants had undergone Prostate-Specific Antigen testing, 73.6% had no knowledge about prostate cancer, and 75% had no knowledge about early detection tests for prostate cancer. Furthermore, participants who had knowledge about prostate cancer and early detection, had a family history of prostate cancer, and considered undergoing prostate examination had a higher rate of undergoing Prostate-Specific Antigen testing. Those who had never undergone a prostate examination, had no knowledge about prostate cancer and early detection tests, and did not plan to undergo prostate examination within the next six months had higher scores on the barrier perception scale, while those who had undergone Prostate-Specific Antigen testing and planned to undergo prostate examination within the next six months had higher scores on the health motivation perception scale. &#x0D; Conclusion: The study revealed a low rate of Prostate-Specific Antigen testing for early detection of prostate cancer, and participants' knowledge and health beliefs and perceptions related to prostate cancer and early detection tests were identified as key factors influencing prostate cancer screening behaviors.

Abstract 2220: Associations between post-diagnostic lifestyle and dietary patterns with prostate cancer survival in the Multiethnic Cohort

Abstract Background: Prostate cancer (PCa) remains a leading cause of cancer-related death among men despite high 5-year survival rates for localized and regional diseases. This study evaluated healthy lifestyle and dietary patterns in relation to PCa survival in a multiethnic population. Methods: We prospectively followed 2,603 men with non-metastatic PCa in the Multiethnic Cohort (MEC) for a median duration of 10.9 years (497 African American, 754 Japanese American, 577 Latino, 129 Native Hawaiian, and 646 White men) starting in 1993. We documented 1,321 deaths, including 196 from PCa. Lifestyle pattern was assessed after diagnosis by a previously reported PCa Behavior Score, which includes BMI, physical activity, and smoking, and a modified version including diet (based on the sum of saturated fat, whole milk, alcohol, and processed meat intake). We also evaluated six indices of inflammatory and insulinemic potential of diet and lifestyle patterns (E-DII, EDIP, EDIH, ELIH, EDIR, and ELIR); and three indices of plant-based diets: an overall plant-based diet index (PDI), a healthful PDI (hPDI), and an unhealthful PDI (uPDI). We used Cox proportional hazards models to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the relationship between each index with PCa-specific and all-cause mortality. We adjusted for education, race/ethnicity, smoking, BMI, physical activity (if not part of the score), family history of PCa, and first course of treatment. Results: Across the five racial/ethnic groups, Japanese American men exhibited healthier lifestyle and dietary patterns post-diagnosis, while African American and Native Hawaiian men tended to have less healthy behaviors. The PCa Behavior Score was statistically significantly associated with a reduced risk of all-cause mortality (HR per point=0.71, 95% CI 0.63-0.80), and a similar trend persisted when incorporating diet into the score. The PDI was statistically significantly inversely associated with all-cause mortality (HR per SD=0.90, 95% CI 0.83-0.97), while the uPDI showed a positive association (HR=1.10, 95% CI 1.12-1.18). None of the lifestyle or dietary patterns were associated with PCa mortality (p-values&amp;gt;0.05). No clear trends were observed for inflammatory and insulinemic dietary patterns after PCa diagnosis with all-cause or PCa-specific mortality. Conclusion: Adopting a healthy lifestyle and diet was associated with longer overall survival among men with PCa. We did not find these practices to be associated with a lower risk of PCa-specific mortality among men diagnosed with non-metastatic disease. However, 85% of the observed deaths during follow-up were due to other causes; this underscores the importance of counseling all men, including those with non-metastatic prostate cancer on health behaviors to manage comorbidities. Citation Format: Anqi Wang, Erin L. Van Blarigan, Iona Cheng, June M. Chan, Peggy Wan, Song-Yi Park, Fei Chen, Loic Le Marchand, Lynne Wilkens, Stacey A. Kenfield, Christopher A. Haiman. Associations between post-diagnostic lifestyle and dietary patterns with prostate cancer survival in the Multiethnic Cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2220.

Precursor lesions in familial and hereditary pancreatic cancer.

Infiltrating ductal adenocarcinoma of the pancreas, referred to here as "pancreatic cancer," is one of the deadliest of all of the solid malignancies. The five-year survival rate in the United States for individuals diagnosed today with pancreatic cancer is a dismal 12%. Many invasive cancers, including pancreatic cancer, however, arise from histologically and genetically well-characterized precursor lesions, and these precancers are curable. Precursor lesions therefore are an attractive target for early detection and treatment. This is particularly true for individuals with an increased risk of developing invasive cancer, such as individuals with a strong family history of pancreatic cancer, and individuals with a germline variant known to increase the risk of developing pancreatic cancer. There is therefore a need to understand the precursor lesions that can give rise to invasive pancreatic cancer in these individuals.

Prospective evaluation of the Kaiser Permanente prostate cancer risk calculator in biopsy-naïve men with mild PSA elevations.

290 Background: To assess the impact on biopsy outcomes in biopsy-naïve men with mild PSA elevations (&lt;10 ng/ml) when provided risk estimates using a novel prostate cancer risk calculator. Methods: This prospective study was conducted in urology departments in Kaiser Permanente Northern California in men with PSA elevations that were &lt;10 ng/ml between March 2021 and March 2023. Patient variables (age, race, family history of prostate cancer, body mass index, and PSA level) were entered into our validated calculator. Risk estimates for high-grade cancer (Gleason score ≥7) and overall cancer were shared with the patient who accepted or declined the biopsy. We compared age, race, family history for prostate cancer, BMI, PSA level, predicted high-grade and overall cancer risks between those that accepted and those that declined biopsy. The outcomes of those who underwent biopsy were compared to historical data of biopsy-naïve men with PSA elevations &lt;10 ng/ml who underwent biopsy in the three years prior to the Covid pandemic between January 2016 and December 2019 (n=5141). Results: After 24 months, the calculator was used to estimate risk for 1962 biopsy-naïve men with mild PSA elevations. 1455 (74%) accepted the biopsy. Those with a family history for prostate cancer were slightly more likely to accept biopsy. Age (continuous and categorical), and BMI (continuous and categorical) were not associated with decision for biopsy. Similarly, race/ethnicity when analyzed as four categories (White, Black, Asian, Hispanic) or as two categories (Black vs. all others) was not associated with decision for biopsy. The men who accepted the biopsy had higher predicted median high-grade cancer risks (24% [IQR 17-31%] vs. 20% [IQR 14-29%]; p&lt;0.0001) and higher predicted median overall cancer risks (48% [IQR 40-56%] vs 45% [IQR 37-53%], respectively; p&lt;0.0001) than those who declined the biopsy. Compared to the historical group, use of the risk calculator resulted in a biopsy population enriched with high-grade cancer: 29% vs 25%; similar rates of low-grade cancer: 24% vs 24%; and fewer negative biopsies: 47% vs. 51%, respectively; overall p=0.013. Conclusions: In biopsy-naïve men with mild PSA elevations, use of our risk calculator resulted in a biopsy population that had more high-grade cancer and fewer negative biopsies compared to a historical group. Only family history and higher predicted cancer risks by the calculator were associated with biopsy acceptance.

Higher insoluble fiber intake is associated with a lower risk of prostate cancer: results from the PLCO cohort

Studies regarding the relationship between fiber intake and prostate cancer (PCa) have conflicting results. Therefore, this study examined the relationship between fiber intake and the risk of PCa by using data from Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial. A total of 54,336 participants in the United States, consisting of 6,414 patients with PCa, were included in this study. Multivariate Cox regression models were applied to estimate adjusted hazard ratios (aHRs) and corresponding 95% confidence intervals (CIs). Compared with individuals in the lowest quartile, individuals in the highest quartile of insoluble fiber intake had a significantly lower risk of PCa (aHR, 0.87; 95% CI, 0.78–0.98). By contrast, no significant associations were detected between total fiber intake (aHR, 0.90; 95% CI, 0.80–1.01) or soluble fiber intake (aHR, 0.90; 95% CI, 0.80–1.02). Subgroup analyses showed that insoluble fiber was related to a decreased risk of PCa in subjects with the following characteristics: age > 65 years, nonsmoking or former smokers, education level ≤ high school, non-Hispanic white ethnicity, or without a family history of PCa. In addition, significant combined effects of insoluble fiber intake, age and family history of PCa on the risk of PCa were observed, but no combined effects of smoking status and insoluble fiber intake were observed. In addition, total fiber, insoluble fiber, and soluble fiber intake had no influence on the mortality of PCa patients. These results show that all 3 measures of fiber suggest a protective association, but insoluble fiber may have a stronger association with the risk of PCa. Future studies are warranted to further investigate these relationships.

Abstract A015: Impact of healthy lifestyles and polygenic risk scores on pancreatic cancer risk: The Multiethnic Cohort Study

Abstract Background: Healthy lifestyles have been observed to reduce the risk of pancreatic cancer. However, it is unknown whether this protective impact varies among individuals with different levels of genetic susceptibility for pancreatic cancer. Methods: We investigated the association between healthy lifestyles, genetic risk, and pancreatic cancer incidence in 70,780 participants (32,783 males, 37,907 females) from the Multiethnic Cohort Study (MEC), a prospective cohort of White, African American, Native Hawaiian, Japanese American, and Latino men and women. We calculated a healthy lifestyle factor score (HLFS) based on smoking status, alcohol intake, body mass index and physical activity. We also estimated genetic risk using an established polygenic risk score (PRS) of 49 pancreatic cancer risk variants. Cox regression was used to assess the independent and joint associations of the HLFS (analyzed as quintiles) and PRS (analyzed as quintiles and high/low categories) with pancreatic cancer risk. Models were adjusted for age at blood draw, sex, race, family history of pancreatic cancer, and in the genetic analyses, the first ten principal components to account for population stratification. Results: The analytical cohort was comprised of 23,643 (33.4%) Japanese Americans, 16,816 (23.8%) Latinos, 14,305 (20.2%) Whites, 10,645 (15.0%) African Americans, and 5,371 (7.6%) Native Hawaiians. There were 721 incident cases of pancreatic cancer from an average follow-up period of 13.7 (SD 4.8) years. Higher levels of the PRS were associated with a 25-62% increase in pancreatic cancer risk, compared to the first PRS quintile. These elevated risks were borderline significant for quintile 2 (HR 1.25, 95% CI 0.97-1.61) and statistically significant for quintile 3 (HR 1.35, 95% CI 1.05-1.73), quintile 4 (HR 1.46, 95% CI 1.15-1.87), and quintile 5 (HR 1.62, 95% CI 1.27-2.06). For the HLFS, higher quintiles were associated with a 10-27% decreased risk of pancreatic cancer, compared to the lowest quintile, but this was only statistically significant for the highest quintile (HR 0.73, 95% CI 0.56-0.94). When evaluating the HLFS by levels of the PRS (low 0-50% vs. high 50-100%), the association between the highest HLFS quintile and pancreatic cancer was more pronounced among those in the high PRS group (HR 0.64, 95% CI 0.45-0.91), compared to those in the low PRS group (HR 0.80, 95% CI 0.55-1.18). However, this difference in effect by PRS levels was not statistically significant (p-interaction=0.43). Conclusions: Our study demonstrates that including information on healthy lifestyles and genetic risk may improve the risk stratification of pancreatic cancer for multiethnic populations. In addition, it is possible that healthy lifestyles could provide more benefit to individuals at higher genetic risk. Citation Format: Brian Huang, Adelynn Paik, David Bogumil, Fei Chen, Peggy Wan, Lynne Wilkens, Loic Le Marchand, David Conti, Christopher Haiman, Veronica Wendy Setiawan. Impact of healthy lifestyles and polygenic risk scores on pancreatic cancer risk: The Multiethnic Cohort Study [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Pancreatic Cancer; 2023 Sep 27-30; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(2 Suppl):Abstract nr A015.

Assessment of the Psychosocial Impact of Pancreatic Cancer Surveillance in High-Risk Individuals.

Pancreatic cancer (PC) surveillance of high-risk individuals (HRIs) downstages PC and improves survival. However, it remains less clear whether PC surveillance has a positive psychosocial impact on HRIs. Herein, we aimed to define the attitudes and beliefs of HRIs undergoing PC surveillance, and the immediate and sustained psychosocial impact of PC surveillance in HRIs. 100 HRIs undergoing PC surveillance by endoscopic ultrasound (EUS) completed three surveys addressing different components of the psychosocial impact of PC surveillance. Logistic regression analyses were performed to identify predictive factors relating to these components. Most HRIs reported increased perceived benefits of PC surveillance, self-efficacy, and perceived severity of PC. HRIs reported few negative emotions prior to surveillance and frequent positive emotions after surveillance. Compared to prior to surveillance, there was a 53.5% decrease in the level of distress reported by HRIs after surveillance, which was sustained for 4-6 weeks post-surveillance. Family history of PC and lower self-reported mental health were identified as predictors for increased perceived susceptibility to PC (p < 0.01) and greater change in distress pre- to post-surveillance (p < 0.01), respectively. Our findings suggest that PC surveillance can lead to sustained psychosocial benefits in HRIs.

A non-socially-sensitive predictive model of prostate cancer for Asian males with benign prostatic hyperplasia: A multi-site cross-sectional case-control study

Background Benign prostatic hyperplasia (BPH) is common in aging Asian males and is associated with an excess risk of developing prostate cancer (PCa). However, discussions about socially-sensitive experiences such as sexual activity, which can significantly predict PCa risk, may be considered stigmatized in Asian culture. This study aimed to develop a predictive model for PCa risk in Asian males with BPH using non-socially-sensitive information. Methods A cross-sectional case-control study, with PCa patients as the cases and remaining as the controls, was conducted on a cohort of Taiwanese males with BPH from four medical institutions. Patients who met the inclusion criteria were enrolled, excluding those aged over 86 years or who had received human papillomavirus (HPV) vaccination. Non-socially-sensitive variables such as obesity, occupational exposure, HPV infection, and PCa family history score (FH score) were included in a fully adjusted logistic regression model, and depicted using a nomogram. Results Among 236 BPH patients, 45.3% had PCa. Obesity, occupational exposure, HPV infection, and family history of PCa were significantly associated with PCa risk. The FH score (OR = 1.89, 95% CI = 1.03–3.47, P = 0.041) had the highest impact, followed by HPV infection (OR = 1.47, 95% CI = 1.03–2.11, P = 0.034), occupational exposure (OR = 1.32, 95% CI = 1.15–1.51, P &lt;0.001), and obesity (OR = 1.22, 95% CI = 1.07–1.41, P = 0.005). The nomogram accurately depicted the predictive risk, and the model demonstrated robust performance compared to individual factors. In addition, the subgroup analysis results showed elderly age group could obtain more favorable predictive performance in our proposed model (AUC = 0.712). Conclusion This non-socially-sensitive predictive model for PCa risk in Taiwanese males with BPH integrates multiple factors that could provide acceptable PCa risk-predictive performance, especially for elderly BPH patients over 70 years, aiding clinical decision-making and early cancer detection.

Abstract C087: Association of serum lipid profile with prostate cancer risk and aggressiveness in Nigerian men

Abstract OBJECTIVE Though prostate cancer (PCa) is the most common cancer and cause of cancer death among Nigerian men, its relationship with serum lipid profiles, a biochemical measurement of dietary fat, has not been explored among Nigerian men. The study aimed to determine the association of serum lipid profile with prostate cancer risk and aggressiveness. METHODS The study was a case-control conducted at University College Hospital, Ibadan, Nigeria. The cases were newly diagnosed prostate cancer patients ages 50-75 years, while the controls were age-matched healthy men with confirmed normal PSA. Participants with uncontrolled comorbidities, poor performance status (ECOG ≥3), and weight loss in the past month were not eligible. The patient characteristics (age, marital status, employment status, highest level of education, high-fat diet, lack of exercise, tobacco smoking, alcohol intake, family history of prostate cancer, comorbidities, and tumor characteristics [PSA at presentation, histology, Gleason score, and stage at presentation] in the cases alone) were collected using an interviewer-administered questionnaire. A serum lipid profile test (including total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) was done in all participants. Analysis of the variables was on SPSS version 23.0, with a t-test to compare the serum lipid profile between the case and control groups, a chi-square to compare the sociodemographic and patient characteristics between both groups and an ANOVA test to determine the association between serum lipid profile and Gleason's score (disease grade) or stage of prostate cancer. RESULTS Enrolled in each group were seventy-four participants. The mean age ± standard deviation was 65.0 ± 5.9 years for cases and 63.0 ± 6.5 years for controls. Participants with a high-fat diet (p = 0.006), physical inactivity (p = 0.046), alcohol consumption (p = 0.005), and family history (p = 0.002) were significantly higher in the case group than the controls. A high proportion of the cases had high-grade disease (GS ≥ 8) [39.2%] and stage 4 disease (35.2%). The mean levels of TC (p&amp;lt;0.001) and HDL-C (p&amp;lt;0.001) were significantly higher in the cases. The mean TG increased while HDL-C decreased as the disease stage advanced but with no statistical significance. While the mean TC (p = 0.001) increased significantly with worsening prostate cancer grade, the mean HDL-C was highest in low-grade disease (p &amp;lt;0.001). CONCLUSION Elevated total cholesterol and high-density lipoprotein cholesterol were associated with increased prostate cancer risk. While elevated total cholesterol was associated with high-grade prostate cancer, a high level of high-density lipoprotein cholesterol was associated with the low-grade disease. Hence, regular serum lipid profile tests may be encouraged among Nigerian men for early detection and treatment of any cholesterol derangement to avoid its predisposition to prostate cancer. Citation Format: Kehinde Oluwatosin Adeyinka, Adeniyi Adenipekun, Atara Ntekim, Augustine Oghenewveyin Takure, Rotimi Solomon. Association of serum lipid profile with prostate cancer risk and aggressiveness in Nigerian men [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr C087.

Prostate-specific antigen testing rates in high-risk populations: results from the All of Us Research Program

BackgroundEarly detection of prostate cancer using prostate-specific antigen (PSA) remains controversial and disparities in the receipt of prostate cancer screening persist in the US. We sought to examine disparities in PSA testing rates among groups with higher prostate cancer risk and differential access to healthcare.MethodsWe identified a cohort of 37,706 males within the All of Us Research Program without a history of prostate cancer between the ages of 40 and 85 at time of enrollment (2017–2021). Incidence rate ratios (IRR) for the number of PSA tests received during follow-up through December 2021 were estimated using age- and multivariable-adjusted negative binomial regression models. PSA testing frequencies in the cohort were compared with population-based estimates from the 2020 Behavioral Risk Factor Surveillance System (BRFSS).ResultsA total of 6,486 males (17.2%) received at least one PSA test over the course of follow-up. In multivariable-adjusted models, non-Hispanic Black males received PSA tests at a 17% lower rate (IRR = 0.83, 95% CI 0.76, 0.90) than non-Hispanic White males. Higher educational attainment, higher annual income, having self-/employer-purchased insurance, having a spouse or domestic partner, and having a family history of prostate cancer were all associated with higher rates of PSA testing. The proportion of males ages 55 to 69 who received a PSA test within two years was lower in All of Us (12.4%, 95% CI 11.8–13.0%) relative to population-based estimates from the BRFSS (35.2%, 95% CI 34.2–36.3%).ConclusionAbsolute PSA testing rates in All of Us were lower than population-based estimates, but associations with PSA testing in the cohort mirrored previously reported disparities in prostate cancer screening. These findings highlight the importance of addressing barriers to care in order to reduce disparities in cancer screening.

Sexually and Non-sexually Transmitted Infections and The risk of Prostate Cancer

Abstract Introduction Prostate cancer (PCa) is by far the most common type of cancer among men in western countries. However, relatively little is known about its etiology despite the high morbidity and mortality rates, where only advanced age, ethnicity, and family history of prostate cancer are well-established non-modifiable risk factors. It has been suggested that chronic inflammation may be involved in the development of prostate carcinogenesis. Therefore, our objective was to investigate the role of sexually and non-sexually transmitted infections in the occurrence of prostate cancer with a specific interest in the aggressive types based on data from EPICAP. Methods EPICAP is a population-based case-control study conducted in the département of Hérault, France, between 2012 and 2014. A total of 819 incident cases and 879 controls were interviewed face-to-face using a standardized questionnaire gathering information on known or suspected risk factors of prostate cancer and personal history of specific sexually and non-sexually transmitted infections: Gonorrhea, Syphilis, Trichomonas, Herpes, Mononucleosis, Epstein Barr, Varicella-zoster, and Dengue. Odds Ratios (OR) and their 95% confidence interval were estimated using multivariate unconditional logistic regression. Results No association emerged for the history of sexually transmitted infections (OR 1.04, 95%CI: 0.84-1.25) and non-sexually transmitted infections (OR1.09, 95%CI: 0.89-1.34) and the risk of prostate cancer. Even for all the infections studied separately, there was no association with the risk of low-grade or high-grade prostate cancer. Conclusions Our results showed that sexually or non-sexually transmitted infections do not seem to be risk factors for prostate cancer in the EPICAP study. Therefore, further investigation is needed to help advance our understanding of the role of chronic inflammation in the etiology of prostate cancer, with a particular focus on its most aggressive types.

Diabetes and pancreatic cancer risk in a multiracial cohort.

To determine the relationship of diabetes with pancreatic cancer incidence among African American and Whites of similar socio-economic status. Using the Southern Community Cohort Study, we conducted a follow-up during 2002-2015 of pancreatic cancer incidence of 73,378 mostly low-income participants aged 40-79 years; 15,913 reported diabetes at baseline. Multivariable Cox analysis controlling for sex, family history of pancreatic cancer, BMI, smoking status, alcohol consumption, education, income and other important covariates, and with age as the timescale was used. Totally, 265 incident pancreatic cancer cases were observed. Pancreatic cancer risk was increased among those with diabetes (HR 1.54, CI 1.16-2.05), with similar increases among African Americans (HR 1.51, CI 1.08-2.11) and Whites (HR 1.78, CI 1.00-3.16). No trend in risk was observed for diabetes duration among those with diabetes, with HRs of 1.39 (0.91-2.11), 2.31 (1.51-3.54) and 1.23 (0.80-1.89) for <5, 5-9 and 10+ years duration, respectively. African Americans were at increased risk of pancreatic cancer (HR = 1.40, 95% CI 1.05-1.87), which persisted after adjusting for diabetes (HR 1.36, CI 1.02-1.81). The effect sizes for other pancreatic cancer risk factors with pancreatic cancer were similar by diabetes status, although a stronger association with low BMI was evident among those with diabetes. Diabetes increases pancreatic cancer risk similarly among African Americans and Whites in this Southern U.S.

Knowledge of prostate cancer and its screening among males attending Urology OPD in a tertiary care hospital in Kathmandu

Prostate cancer is a global burden on public health and it has been ranked as the second most common cancer in males worldwide. The incidence of prostate cancer generally increases with age and men with family history of prostate cancer have an increased risk of getting prostate cancer. The incidence varies across the world, where developed countries have a higher incidence as compared to developing countries. It is well known that early detection of certain grades of prostate cancer leads to a higher remission rate. Starting the screening for prostate cancer at the age of 40 for specific population provides the only way to reduce mortality from prostate cancer. A cross sectional hospital study was conducted using Consecutive sampling of eligible patients in the Urology Outpatient Department (OPD) of a tertiary care hospital in Kathmandu. A total of 378 patients attending Urology OPD were included in the study. A structured questionnaire which was sectioned into sociodemographic characteristics, knowledge of prostate cancer and its screening practices was administered to all the participants. Male more than 60 years of age attending Urology OPD were more (33.3%) followed by age group less than 40 years of age (28.6%). The majority of the patients visiting Urology UPD were from Province 3 (73.0%) and Province 1 (11.1%). Most of these patients were literate (34.9%) but the education level of college or higher were less (17.7%). When knowledge of prostate cancer among the participants were assessed, 55.6% participants replied that they have heard about the prostate cancer and among them, the majority of the participants (28.6%) had heard it from media like TV, radio and internet. The most common symptoms chosen by patients were hematuria (80.2%) and weight loss (72.0%). When asked about the prevention and cure of prostate cancer, 61.1% and 78.6% of them did not know about the prevention and its cure respectively. When knowledge on screening of prostate cancer was assessed, more than half of the participants were found to be aware of screening test and among them 94.4% chose blood test, Serum Prostate Specific Antigen (PSA) as the screening test. Majority of the patients (61.4%) had chosen the age for screening as &lt;40 years and many more (91.3%) wanted to go for screening. Overall, 55.6% had heard about prostate cancer and 30.7% did not know any symptoms of prostate cancer. This study identifies some deficits in knowledge of prostate cancer and screening among participants which can be addressed to increase the knowledge related to prostate cancer. It is thus important that these participants and other men be educated more on these important domains of prostate cancer.

Outcomes of the IMMray PanCan-d Test in High-Risk Individuals Undergoing Pancreatic Surveillance: Pragmatic Data and Lessons Learned.

An effective blood-based test for pancreatic cancer (PC) screening has remained elusive. The IMMray PanCan-d is the first commercially available blood-based test specifically designed for early detection of PC; however, outcomes from its use in clinical practice have not been reported. We performed a blinded spike-in study of 100 individuals who had an IMMray PanCan-d test, including 94 high-risk individuals (HRIs) undergoing PC surveillance and six individuals with known PC. Specimens were processed blindly following the commercial laboratory's standardized operating procedure. Positive predictive value (PPV) and negative predictive value (NPV) were calculated. Cohort characteristics included a median age of 63 (IQR, 55-70) years, 57% female, 96% non-Hispanic White, 57% with a pathogenic variant in a PC risk gene (BRCA2 most commonly-18%), and 83% with a family history of PC. Among IMMray PanCan-d results from 94 HRIs undergoing PC surveillance, there was one positive (1%), seven borderlines (7%), 73 negatives (78%), and 13 tests not performed because of low CA19-9 expression (14%). No PC was diagnosed among these HRIs; however, there were two sub-cm pancreatic neuroendocrine tumors, seven clinically diagnosed side branch intraductal papillary mucinous neoplasms ≥1 cm, and a sub-cm solid mass with indeterminate cytology requiring close follow-up; all these individuals had negative IMMray PanCan-d tests. Of the six spiked-in PCs, four (67%) yielded a positive and two (33%) yielded a negative. With an estimated disease prevalence of 2%, the PPV and NPV are 52% and 99%, respectively, if borderline results are considered negative and 12% and 99%, respectively, if borderline tests are considered positive. In clinical practice, IMMray PanCan-d has a robust NPV; however, PPV is dramatically influenced by whether borderline results are characterized as a positive or negative result.