Grönberg H, Wiklund F, Damber J E
Department of Oncology, Umeå University, Sweden.
Cancer. 1999 Aug 1;86(3):477-83.
A positive family history is one of the strongest known risk factors for prostate carcinoma in addition to age and race. In this article, the authors present age specific risks for developing prostate carcinoma in families with an aggregation of prostate carcinoma.
Data from a population-based cohort study including 5706 sons of Swedish men who had been diagnosed with prostate carcinoma between 1959 and 1963 were used. The age specific incidence rates were calculated for different cohorts of prostate carcinoma families with respect to patient age at the time of prostate carcinoma diagnosis and the number of men affected.
Both patient age at the time of prostate carcinoma diagnosis and the number of men affected in the families influenced the risk of developing prostate carcinoma significantly. Unaffected men in families with two or more cases of prostate carcinoma have a very high risk of developing prostate carcinoma at a young age. The cumulative risks in these families are 5%, 15%, and 30% by ages 60 years, 70 years, and 80 years, respectively, compared with only 0.45%, 3%, and 10%, respectively, at the same ages in the general population.
The findings of the current study together with data from the literature support the case for the screening of high risk families. The authors also conclude that men with at least two close relatives with prostate carcinoma have a very high risk of developing prostate carcinoma before age 70 years. The authors recommend these men undergo testing for prostate specific antigen and a digital rectal examination annually between the ages 50 years 70 years, ages at which patients usually are offered curative treatment for localized tumors. Screening of individuals before age 50 years may be recommended in selected families with a history of prostate carcinoma of very early onset.
除年龄和种族外，家族史是已知的前列腺癌最强风险因素之一。在本文中，作者呈现了前列腺癌聚集家族中前列腺癌发病的年龄特异性风险。
使用了一项基于人群的队列研究数据，该研究纳入了1959年至1963年间被诊断为前列腺癌的瑞典男性的5706名儿子。针对不同队列的前列腺癌家族，根据前列腺癌诊断时的患者年龄和受影响男性的数量计算年龄特异性发病率。
前列腺癌诊断时的患者年龄以及家族中受影响男性的数量均显著影响前列腺癌发病风险。在有两例或更多例前列腺癌的家族中，未受影响的男性在年轻时患前列腺癌的风险非常高。这些家族在60岁、70岁和80岁时的累积风险分别为5%、15%和30%，而在普通人群中同一年龄段的累积风险分别仅为0.45%、3%和10%。
当前研究结果与文献数据均支持对高危家族进行筛查。作者还得出结论，至少有两个近亲患前列腺癌的男性在70岁前患前列腺癌的风险非常高。作者建议这些男性在50岁至70岁之间每年进行前列腺特异性抗原检测和直肠指检，这一年龄段的患者通常可接受针对局限性肿瘤的根治性治疗。对于有前列腺癌极早发病家族史的特定家族，可能建议在50岁之前对个体进行筛查。
