Prostate cancer risk: When does family history increase your chances of developing the disease?
New Delhi: A family history of prostate cancer can play an important role in assessing a man’s chances of developing the disease, but having an affected relative does not mean cancer is inevitable. The relationship between family history and prostate cancer risk depends on several factors, including which relative was diagnosed, the age at diagnosis and whether multiple family members have been affected. Understanding these patterns can help men identify whether they may need to discuss screening earlier than usual.
In a communication to News9 Digital, Dr Gokulakrishnan PJ, Lead Consultant and HOD, Department of Urology, Aster Whitefield Hospital, explained how family history influences prostate cancer risk and when men should consider screening. Dr Sunit Lokwani, Medical Oncology and Clinical Haematology, HCG Cancer Hospital, Indore, also highlighted the importance of recognising inherited cancer patterns.
When does family history increase prostate cancer risk?
Family history is one of the important factors doctors consider while assessing a man’s prostate cancer risk. Emphasising the importance of asking about relatives’ diagnoses, Dr Gokulakrishnan said, “In terms of risks for prostate cancer, one of the best questions that can be asked is the one that is usually forgotten: Have any of your relatives been affected by prostate cancer, and what was their age at the time of their diagnosis?”
According to the National Cancer Institute, having a first-degree relative, such as a father, brother or son, with prostate cancer is a recognised risk factor. The age at which the relative was diagnosed also matters when assessing the significance of family history.
How many affected relatives raise the risk?
The number of close relatives diagnosed with prostate cancer can influence an individual’s risk. Having an affected father or brother can approximately double the risk, while multiple affected relatives, particularly those diagnosed at younger ages, can indicate a greater likelihood of inherited susceptibility.
However, family history does not make the disease inevitable. Prostate cancer also occurs in men without any known family history of the condition. The important consideration is whether the pattern of diagnoses within a family suggests an increased risk.
The age at diagnosis can offer additional clues. For instance, a father diagnosed at 78 may indicate a different family risk pattern from one diagnosed at a much younger age. Doctors therefore need to consider both the number of affected relatives and their ages when evaluating a man’s individual risk.
Why other cancers in the family matter
A family history of cancer should not be limited to prostate cancer alone. Certain inherited genetic changes can increase susceptibility to multiple cancer types, making it important to consider the broader family history.
Mutations in the BRCA1 and BRCA2 genes have been associated with an increased risk of prostate cancer. Lynch syndrome, an inherited condition associated with several cancer types, can also be relevant when assessing familial cancer risk.
Explaining the significance of these patterns, Dr Sunit Lokwani said, “It is just as important to consider cancers other than prostate cancer; a family history of some types of cancer, such as breast, ovarian, pancreatic and prostate cancer, especially if these cancers occur at a relatively young age or if they appear more than once in the same family, may indicate the presence of inherited genetic changes such as BRCA1 or BRCA2.”
Such patterns may prompt doctors to consider genetic counselling or testing, depending on the individual’s personal and family history. Identifying a possible inherited predisposition can help guide discussions about surveillance and screening.
When should men discuss prostate cancer screening?
The appropriate time to discuss prostate cancer screening depends on age, family history, overall health and personal preferences. Men with a father or brother diagnosed with prostate cancer before the age of 65 are considered at increased risk and should discuss screening with a healthcare professional from the age of 45, according to the American Cancer Society.
Men with more than one first-degree relative diagnosed at an early age may be at even higher risk and should consider these discussions from the age of 40.
Screening may involve a prostate-specific antigen (PSA) blood test. A digital rectal examination may also be considered in some cases. However, an elevated PSA level does not automatically mean a man has prostate cancer, as other conditions can also cause PSA levels to rise. Results must therefore be interpreted in the context of the individual’s health and risk factors.
What details should men know about their family history?
A family history assessment involves more than simply recording whether a relative had cancer. Dr Lokwani said, “Men should be aware not only of whether cancer has occurred in their family but also of which relative was affected, the type of cancer that person had and about how old they were when they were diagnosed.”
He added that these details can influence how risk is evaluated and help doctors determine appropriate screening and follow-up. Men with concerning family histories may benefit from discussing their risk with a healthcare professional, who can advise them on screening, genetic counselling or further assessment where appropriate.
Ultimately, an inherited predisposition increases susceptibility rather than guaranteeing that cancer will develop. Understanding family history can help men and their doctors make informed decisions about when to begin screening discussions and how to approach individual risk.
Disclaimer: This article is based on inputs shared by the doctors mentioned in this article. The findings should not be considered medical advice or used for self-diagnosis or treatment. Consult a qualified healthcare professional for personalised guidance.