by Cambridge scientists have developed a comprehensive tool for estimating an individual’s risk of developing prostate cancer; They say this could help ensure that the men at highest risk get the appropriate tests, while reducing unnecessary – and potentially invasive – testing for those who are very low. risk.
Developed by researchers at the University of Cambridge and the Cancer Research Institute of London, CanRisk-Prostate will be included in the group’s CanRisk web tool, which currently records around 1.2 million risk estimates. The free tool is already used by healthcare professionals around the world to help predict the risk of developing breast and ovarian cancer.
Prostate cancer is the most common type of cancer in men. According to Cancer Research UK, more than 52,000 men are diagnosed with the disease each year, and more than 12,000 deaths occur. More than three-quarters (78%) of men diagnosed with prostate cancer survive for more than ten years, but this proportion has hardly changed in the UK over the past decade.
Prostate cancer testing involves a blood test that looks for a protein known as prostate-specific antigen (PSA), which is made only by the prostate gland; however, it is not always true. According to the NHS website, about three out of four men with high PSA levels will not get cancer. Therefore, further testing, such as tissue biopsies or MRI scans, is necessary to confirm a diagnosis.
Professor Antonis Antoniou, from Cambridge University’s Department of Public Health and Primary Care, said: “Prostate cancer is the most common cancer in men in the UK, but population-wide screening based on PSA is not an option: these tests are often false-positive, which in many It means unnecessary biopsy of the man. Also, many prostate tumors identified by PSA tests grow slowly and are not life-threatening. Treatment of these tumors may do more harm than good.
“What we need is a way to identify the men most at risk, allowing us to target screening and diagnostic testing where they are most needed, while reducing the harm of men at low risk for the disease. CanRisk-Prostate aims to do this. For the first time, the main for disease It provides personalized cancer risks by combining information about genetic makeup and family history of prostate cancer, which are risk factors.”
Prostate cancer is one of the most genetically prevalent cancers. Inherited bad versions BRCA2, HOXB13 and probably BRCA1 genes are associated with a moderate to high risk of prostate cancer, but such errors are rare in the population. In addition, there are several hundred more common genetic variants, each conferring a lower risk, but they act as ‘volume control’, reducing or increasing the overall risk of prostate cancer.
To write Journal of Clinical OncologyResearchers supported by Cancer Research UK describe the development of the first comprehensive prostate cancer model using genetic and cancer family history data from nearly 17,000 families affected by prostate cancer. It uses data on rare genetic errors in intermediate to high-risk genes and a risk score based on 268 common low-risk variables and detailed cancer family history to predict future risk.
One in six men (16%) will develop prostate cancer when they reach the age of 85. Using the model, the team found that the predicted risk was higher for men whose father was diagnosed with prostate cancer – 27% if the father was diagnosed at an older age (age 80), but up to 42% if the father was diagnosed with prostate cancer. diagnosed at a young age (50 years).
For men with genetic defects, the risks were quite high. For example, 54% of men carrying a change in their body BRCA2 gene may develop prostate cancer – however, among men BRCA2 gene defects, the risks were significantly lower if they also had a small number of low-risk variants, but much higher if they also had a large number of low-risk variants.
In practice, the researchers say, clinicians can use any combination of cancer family history, rare and common genetic variants to provide a personalized risk.
To validate their model, the team ran the risk model on an independent cohort of more than 170,000 men who participated in the UK Biobank, a biomedical database and research resource containing anonymized genetic, lifestyle and health information from half a million UK participants. None of these men were prostate cancer survivors when enrolled in the study, but over the next ten years, more than 7,600 developed prostate cancer.
In validating their model, the researchers found that 86% of UK Biobank participants were halfway through men who developed cancer. at highest risk, that the majority of cancers will occur among them.
From the MRC Biostatistics Unit at Cambridge, Dr. Tommy Nyberg said: “We have created the most comprehensive tool to date for estimating a man’s risk of developing prostate cancer. This is based on the ability of clinicians and genetic counselors to assess their clients’ risk and appropriate follow-up.
“Over the next 12 months, we aim to incorporate this tool into the widely used CanRisk tool, which will facilitate risk-based clinical management of men seen in family cancer clinics and enable risk-adjusted early detection approaches for the general population.”
Professor Ros Eeles of the Cancer Research Institute of London and co-author of the study said: “This is an important step in enabling clinicians to talk to men about prostate cancer risks on the most accurate computer basis.” model to date. This will help them make decisions about screening.”
So far, data used to develop CanRisk-Prostate have been obtained from men of European descent. The team hopes to be able to include data from men of other ethnicities as further research is conducted.
Cambridge University recently established the Early Cancer Institute with the goal of detecting cancer early enough to cure it. It is the first physical institute dedicated to early cancer in the UK. A new Cambridge Cancer Research Hospital is also planned for the near future, bringing together clinical and research expertise in a world-class new hospital designed in partnership with patients.
The Institute of Cancer Research and The Royal Marsden NHS Foundation Trust also have an Early Detection and Diagnosis center where a prostate risk clinic has been set up to translate these findings into targeted screening programmes.
The research was supported by the CanRisk program funded by Cancer Research UK. Additional support for CanRisk-Prostate was provided by Prostate Cancer UK, The Institute of Cancer Research, Everyman Campaign, National Cancer Research Network UK, National Cancer Research Institute, NIHR Cambridge Biomedical Research Center and the NIHR Biomedical Research Center at The Institute of Cancer Research. and the Royal Marsden NHS Foundation Trust.
