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AUA: Early Detection of Prostate Cancer (2023): Difference between revisions

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== Risk Factors for Developing Prostate Cancer ==
== Risk Factors for Developing Prostate Cancer ==
=== Black ancestry ===


=== Germline mutations ===
=== Germline mutations ===
* BRCA
* BRCA
**Patients with germline BRCA1 and BRCA2 variants have increased risks of both disease onset and progression.
**BRCA1 and BRCA2 variants have increased risks of both disease onset and progression.
*** Stronger association between BRCA2 carriers and aggressive cancer for whom systematic PSA screening is indicated,
*** Stronger association between BRCA2 and aggressive cancer
****Systematic PSA screening is indicated
**** Biopsy referral threshold 3 ng/mL
**** Biopsy referral threshold 3 ng/mL
** These patients may benefit from both earlier initiation of PSA screening and shorter intervals between screenings.
* Other mutations
**ATM, MLH1, MSH2, MSH6, PMS2, HOXB13, NBS1, and CHEK2
***Need further study
**These patients may benefit from both earlier initiation of PSA screening and shorter intervals between screenings.


=== Family history ===
=== Family history ===
* '''Strong family history criteria'''
* '''Criteria for "strong" family history (2):'''
** '''1) people with one brother or father OR two or more male relatives with one of the following:'''  
*# '''1 brother or father OR ≥2 male relatives with one of the following (3):'''
***'''a) diagnosed with prostate cancer at age <60 years'''
*##'''Diagnosed with prostate cancer at age <60 years'''
***'''b) any of whom died of prostate cancer'''
*##'''Any of whom died of prostate cancer'''
***'''c) any of whom had metastatic prostate cancer.'''
*##'''Any of whom had metastatic prostate cancer.'''
** '''2) family history of other cancers with two or more cancers in hereditary breast and ovarian cancer syndrome or Lynch syndrome spectrum.'''
*#'''family history of other cancers with two or more cancers in hereditary breast and ovarian cancer syndrome or Lynch syndrome spectrum.'''
 
* '''Patients with a strong family history should ideally be genotyped''' to ascertain whether this is associated with a pathogenic variant (e.g., BRCA1/2, Lynch Syndrome, ATM, CHEK2) or one or more of a growing set of identified germline DNA damage-repair mutations found in patients with metastatic prostate cancer diagnoses.
* '''Patients with a strong family history should ideally be genotyped''' to ascertain whether this is associated with a pathogenic variant (e.g., BRCA1/2, Lynch Syndrome, ATM, CHEK2) or one or more of a growing set of identified germline DNA damage-repair mutations found in patients with metastatic prostate cancer diagnoses.
=== Black ancestry ===
== PSA screening ==
== PSA screening ==


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