Division of Preventive Oncology, National Center for Tumor Diseases (NCT), German Cancer Research Center (DKFZ), Heidelberg, Germany.
Medical Faculty Heidelberg, University of Heidelberg, Heidelberg, Germany.
Cancer. 2020 Oct 1;126(19):4371-4378. doi: 10.1002/cncr.33096. Epub 2020 Jul 22.
The question of whether having a family history of prostatic borderline or in situ neoplasia (PBISN) is associated with an increased risk of invasive prostate cancer (PCa) or death from PCa remains unanswered. The objective of the current study was to provide an evidence-based risk estimation for the relatives of patients with PBISN.
Nationwide Swedish family cancer data sets were used for the current study, including data regarding all residents of Sweden who were born after 1931 and their parents. Standardized incidence ratios (SIRs), standardized mortality ratios (SMRs), and lifetime cumulative risks of PCa were calculated for men with different constellations of family history. Family history was defined as a dynamic (time-dependent) variable considering changes during follow-up (1958-2015).
Of the 6,343,727 men in the current study, a total of 238,961 developed invasive PCa and 5756 were diagnosed with PBISN during the follow-up. Men with 1 first-degree relative who was diagnosed with PBISN had a 70% increased risk of invasive PCa (SIR, 1.7; 95% confidence interval, 1.5-1.9) and PCa death (SMR, 1.7; 95% confidence interval, 1.3-2.2) compared with men with no family history of PBISN or invasive PCa. These were rather close to estimates in men with 1 first-degree relative diagnosed with invasive PCa (SIR, 2.1 and SMR, 1.8). A higher risk of PCa in family members was found among patients with a family history of PBISN and/or PCa diagnosed before age 60 years. The results in terms of cumulative risk resembled this trend.
A family history of PBISN appears to be as important as a family history of invasive PCa with regard to an increased risk of invasive PCa or PCa mortality. Such a history should not be overlooked in PCa screening recommendations or in future research regarding familial PCa.
患有前列腺交界性或原位肿瘤（PBISN）家族史是否会增加侵袭性前列腺癌（PCa）或 PCa 死亡的风险，这一问题仍未得到解答。本研究的目的是为 PBISN 患者的亲属提供循证风险评估。
本研究使用了全瑞典家族癌症数据集，包括所有 1931 年后出生的瑞典居民及其父母的数据。为具有不同家族史组合的男性计算了标准化发病比（SIR）、标准化死亡比（SMR）和 PCa 的终生累积风险。家族史被定义为一个动态（时间依赖性）变量，考虑到随访期间（1958-2015 年）的变化。
在本研究的 6343727 名男性中，共有 238961 人被诊断为侵袭性 PCa，5756 人在随访期间被诊断为 PBISN。与没有 PBISN 或侵袭性 PCa 家族史的男性相比，有 1 位一级亲属被诊断为 PBISN 的男性，侵袭性 PCa 的风险增加了 70%（SIR，1.7；95%置信区间，1.5-1.9）和 PCa 死亡（SMR，1.7；95%置信区间，1.3-2.2）。这与有 1 位一级亲属被诊断为侵袭性 PCa 的男性的估计值（SIR，2.1 和 SMR，1.8）非常接近。在有 PBISN 或 PCa 家族史且诊断年龄<60 岁的患者中，家庭成员发生 PCa 的风险更高。累积风险的结果也呈现出这种趋势。
PBISN 家族史与侵袭性 PCa 家族史一样，与侵袭性 PCa 或 PCa 死亡率增加有关。在 PCa 筛查建议或未来关于家族性 PCa 的研究中，不应忽视这种病史。
