The Relationship Between Family History of Prostate Cancer and Prostate Cancer Risk at the Time of Diagnosis in Babol City

Prostate cancer is the most common male urogenital malignancy in many regions of the world, which has been increasing in recent years all over the world, including Asian countries, as well as in Iran. The relative risk of prostate cancer for those who have a family history of this disease in close relatives is almost 2 to 3 times, and the incidence rate increases with the increase in the number of affected relatives. Although family history of prostate cancer is a proven risk factor for this disease, few studies have investigated the relationship between the presence of family history of prostate cancer and the degree of prostate cancer risk. The purpose of this study is to investigate the relationship between the existence of a family history of prostate cancer and the degree of prostate cancer risk at the time of diagnosis.

This case-control study was conducted on 322 patients available prostate cancer patients referred to medical centers affiliated with Babol University of Medical Sciences. Patients were divided into two groups: case (family history of prostate cancer) and control (no family history of prostate cancer). Information about family history, Gleason score, PSA, and clinical stage was extracted from all patients. It was extracted through the file and phone call. A positive family history of prostate cancer is defined as follows: patients who have at least two of their first-degree relatives with prostate cancer at any age. Also, patients who have one first-degree relative and at least two second-degree relatives at any age with prostate cancer. In hereditary prostate cancer, at least 3 first-degree relatives have prostate cancer, or prostate cancer occurs in three consecutive generations of the same family (paternal or maternal). At least two first- or second-degree relatives had early onset prostate cancer under the age of 55. The relationship between the existence of a family history of prostate cancer first-degree relatives include: father, brother, and child, and second-degree relatives include: grandfather, uncle and cousin. the degree of prostate cancer in three groups (Low risk with PSA<10, Gleason score<7, intermediate risk with PSA between 10 and 20 or Gleason score 7, and high risk with PSA>20 or Gleason score>7) at the time of diagnosis was investigated.

The average age of patients when diagnosed with prostate cancer was 67.23±8.97 years, who were in the age range of 43-93 years. 23.3% of the studied patients had a family history of prostate cancer and 1.9% had a hereditary family history of prostate cancer. With the increasing age of diagnosis, the degree of risk of prostate cancer increased, which is statistically significant. Thus, 63.9% of patients who were diagnosed with prostate cancer at the age of 71 years had high-risk prostate cancer, which shows that the risk level of prostate cancer should increase as the age of prostate cancer diagnosis increases (P=0.001). Between the ages of 61 and 70 years, 62 people (44.9%) were at a high risk level, while at the age of 60 years, 33 people were at a high risk level (P<0.001). Also, there was a statistically significant relationship between the positive family history of prostate cancer and the degree of risk (75 positive cases (23.3%) versus 247 negative cases (76.7%) (P<0.05).

The findings of the study showed that there is a positive relationship between the family history of prostate cancer and the degree of prostate cancer risk, which indicates the importance of prostate cancer screening with PSA and digital rectal examination from the appropriate age in these patients.