Case Study: Prostate Cancer: A Closer Look at Risk Factors

January 4, 2016
Case Study: Prostate Cancer: A Closer Look at Risk Factors
New efforts toward improved prostate cancer screening have uncovered a multitude of new genetic variants that could help to identify men who have a substantially higher chance of developing the disease. [iStock/dra_schwartz]

John S. Witte, Ph.D.

Prostate cancer is a relatively common disease with high morbidity and mortality; it is expected to kill more than 27,000 men this year in the U.S. alone.  Screening strategies for prostate cancer have recently changed. The PSA (prostate specific antigen) test, introduced in the 1980s, was performed routinely for years. However, since that time it has been discovered that this test gives positive results for some patients whose prostate tumors may never be a problem, even without treatment. Therefore, the U.S. Preventive Services Task Force has recommended against PSA tests to screen for prostate cancer since 2012. The American Urological Association disagreed with the USPSTF recommendations, and has made more nuanced recommendations that incorporate family history, age, and ethnicity. Nevertheless, this test is no longer routinely recommended or ordered, leaving us without early diagnostic tools.

Despite substantial research into this disease, there remains much work to develop highly sensitive and specific biomarkers. Our lab at UCSF, in collaboration with Kaiser Permanente Research Program on Genes, Environment and Health (RPGEH), recently published research findings (Cancer Discovery, August 2015) that shed new light on genetic risks for prostate cancer, and we have evaluated a risk model for the disease that may have potential in the diagnostic arena.  Our results show the potential value of genotyping large populations to help determine genetic risk variants, which may help improve screening strategies for this common but complex disease. 

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