Personalized Risk Prediction for Prostate Cancer According to Specific Family History

1. Personalized Risk Prediction for Prostate Cancer According to Specific Family History • Frederick S. Albright Ph.D.1, William T. Lowrance, M.D., M.P.H.2, Christopher B. Dechet, M.D.2, • Robert A. Stephenson M.D.2, Lisa A. Cannon Albright Ph.D.3 • 1Pharmacotherapy Outcomes Research Center, Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT • 2 Huntsman Cancer Institute, University of Utah, Salt Lake City, UT • 3Division of Genetic Epidemiology, Department of Medicine, School of Medicine, University of Utah, Salt Lake City, UT BACKGROUND RESULTS • Family history of prostate cancer (PC) is a key risk factor for the disease and may inform targeted screening plans • Impact of PC risk according to number of relatives, age of relative’s diagnosis, and degree of one’s relative with PC is uncertain • Objective: To provide risk estimates for PC based on specific family history Table 1. Relative Risk of Prostate Cancer According to Number of Affected First Degree Relatives • Study Group: • -1,192,768 individuals; (611,799 males) • -17,207 PC diagnoses • RR for PC According to Affected Relative:: • -1 FDR: RR 1.71 [95%CI 1.66-1.76] • -4 FDR: RR 5.29 [95%CI 4.35-6.39] • -In absence of affected FDR, ↑ RR only • after ≥ 2 affected SDR – • RR 1.23 [95%CI 1.16-1.30] • -Affected TDR did not impact risk • Impact of Relative’s Age at Diagnosis: • -Earlier age of diagnosis resulted in ↑ • RR of PC: (FDR < 50yrs, RR 4.02; • FDR 70-79yrs, RR 1.90) • Impact of Maternal vs Paternal Relative:: • -No risk difference based on whether FH • of PC from maternal vs paternal side METHODS Number of affected 2nd and 3rd degree relatives unknown Table 2. Relative Risk of Prostate Cancer According to Number of Affected First and Second Degree Relatives • Study Group: • Utah Population Database (UPDB), which is a computerized genealogical resource linked to the statewide SEER cancer registry • Included over 1 million individuals with at least 12 of their 14 immediate ancestors • Analysis: • All males with specific PC family history constellations (specific patterns of PC family history) were identified in the UPDB • Observed number of PC cases was compared to the number of expected cases using internal cohort-specific rates to obtain a relative risk (RR) estimate • Considered family history out to 3rd degree relatives, number of relatives affected, paternal vs maternal relatives affected, and age at diagnosis CONCLUSIONS • The number of first degree relatives (FDR) and age of diagnosis of FDR significantly impact one’s risk of PC • These data may help guide PC screening policies targeting those at highest risk Table 3. Relative Risk of Prostate Cancer According to Age of First Degree Relative ACKNOWLEDGEMENTS Support provided from the Huntsman Cancer Foundation, National Library of Medicine grant LM009331 (LAC), and partial support for all data sets within the UPDB was provided by HCI, University of Utah, and the HCIs Cancer Center Support grant, P30 CA42014 from NCI. Support from the Utah Cancer Registry, which is funded by Contract  No. HHSN261201000026C from the NCISEER Program with additional support from the Utah State Department of Health and the University of Utah. printed by Medical Graphics & Photography • University of Utah School of Medicine • barbara.stephan@hsc.utah.edu 801.587.3435 • 8/2011