Data from Family History of Early Onset or Lethal Prostate Cancer and the Risk of Prostate Cancer Death in Sweden

<div>AbstractBackground:<p>A family history (FH) of prostate cancer increases the risk of prostate cancer, but its association with prostate cancer mortality remains unclear.</p>Methods:<p>FH was defined as having a first-degree relative who was diagnosed before age 60 or died from prostate cancer. We used Cox regression to estimate associations between FH and prostate cancer characteristics at diagnosis, radical treatment, and prostate cancer death in men born after 1932 and diagnosed with prostate cancer between 1998 and 2020 in Sweden.</p>Results:<p>Among 125,272 men with prostate cancer, 13,193 had an FH of early onset or lethal prostate cancer. At diagnosis, men with FH had 1.4 years lower median age, 0.87 ng/mL lower serum PSA, lower proportion of Gleason score 8 to 10 cancer (14.8% vs. 17.6%), lower odds for metastatic disease [OR, 0.79; 95% confidence interval (CI), 0.73–0.86], and higher odds for radical treatment (OR, 1.25; 95% CI, 1.18–1.32). With a median follow-up of 6.9 years and 12,773 prostate cancer deaths, mortality was lower (crude HR, 0.77; 95% CI, 0.73–0.82) in men with FH. Adjustment for prostate cancer characteristics attenuated this association (adjusted HR, 0.94; 95% CI, 0.88–1.00).</p>Conclusions:<p>Men with prostate cancer and an FH of early onset or lethal prostate cancer had more favorable cancer characteristics, a higher likelihood of radical treatment, and similar prostate cancer mortality compared with men without an FH.</p>Impact:<p>In men with prostate cancer, the risk of prostate cancer death seems unaffected by an FH of early onset or lethal prostate cancer after controlling for clinical characteristics. More research is needed on the potential role of screening.</p></div>