Prostate cancer risk in men with prostate and breast cancer family history: Results from the REDUCE study (R1) Journal Article

Authors: Thomas, J. A.; Gerber, L.; Moreira, D. M.; Hamilton, R. J.; Bañez, L. L.; Castro-Santamaria, R.; Andriole, G. L.; Isaacs, W. B.; Xu, J.; Freedland, S. J.
Article Title: Prostate cancer risk in men with prostate and breast cancer family history: Results from the REDUCE study (R1)
Abstract: Background. To what degree the associations between PCa risk and family history of prostate cancer (PCa) and/or breast cancer (BCa) are attributable to screening biases is unclear. We examined these questions within the REDUCE study, where biopsies were largely independent of prostate specific antigen (PSA) minimizing screening biases. Methods. Data were from REDUCE, which tested dutasteride 0.5mg daily for PCa risk reduction in men with PSA 2.5-10.0ngmL -1 and a negative prestudy biopsy. Among men undergoing at least one on-study biopsy with complete data (n=6415; 78.1%), the association between family history and PCa risk was tested using multivariate logistic regression adjusting for clinicodemographic characteristics. Results. A family history of PCa alone was associated with increased PCa diagnosis (OR: 1.47, 95%CI: 1.22-1.77). In North America, PCa family history was not related to PCa diagnosis (OR: 1.02, 95%CI: 0.73-1.44), whereas outside North America, PCa family history was significantly related to diagnosis (OR: 1.72, 95%CI: 1.38-2.15) (P-interaction=0.01). A family history of both PCa and BCa (OR: 2.54, 95%CI: 1.72-3.75) but not BCa alone (OR: 1.04, 95%CI: 0.84-1.29) was associated with increased PCa risk versus no family history and irrespective of geographical region. Conclusions. In REDUCE, PCa family history was significantly related to PCa diagnosis, although only for men outside North America. The presence of both PCa and BCa family history significantly increased risk versus PCa family history alone, irrespective of geographical region. Ultimately, our observations may support the need for changes in how we address family history in terms of both risk of PCa diagnosis and general risk stratification. © 2012 The Association for the Publication of the Journal of Internal Medicine.
Keywords: adult; controlled study; human tissue; aged; middle aged; major clinical study; placebo; cancer risk; cancer grading; prostate specific antigen; cohort studies; breast cancer; tumor volume; randomized controlled trial; logistic models; drug administration schedule; incidence; odds ratio; risk factors; tumor biopsy; breast neoplasms; risk assessment; prostate cancer; prostatic neoplasms; multicenter study; anticarcinogenic agents; family history; multivariate analysis; dutasteride; double blind procedure; double-blind method; medical history taking; reduce; 5-alpha reductase inhibitors; azasteroids
Journal Title: Journal of Internal Medicine
Volume: 272
Issue: 1
ISSN: 0954-6820
Publisher: Wiley Blackwell  
Date Published: 2012-07-01
Start Page: 85
End Page: 92
Language: English
DOI: 10.1111/j.1365-2796.2011.02504.x
PROVIDER: scopus
PUBMED: 22211699
PMCID: PMC3576469
Notes: --- - "Export Date: 1 August 2012" - "CODEN: JINME" - "Source: Scopus"
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