MedicalResearch.com Interview with:
Anna Plym PhD
Department of Medical Epidemiology and Biostatistics,
Karolinska Institutet, Stockholm, Sweden
Department of Epidemiology, Harvard T. H. Chan School of Public Health
Department of Urology, Brigham and Women’s Hospital
Harvard Medical School, Boston, Massachusetts
MedicalResearch.com: What is the background for this study?
Response: Prostate cancer is one of the leading causes of cancer death among men, with approximately one third of the deaths occurring before the age of 75 years. There is a need for a better understanding of the risk factors for those early deaths. Our previous research has indicated that inherited factors play a major role.
MedicalResearch.com: What are the main findings?
Response: In this study we used data from nearly 20,000 men from two independent cohorts and showed that men with an underlying genetic susceptibility have a 3-fold increased risk of dying early from prostate cancer as compared with men at low genetic risk. Close to 90% of the early deaths occurred in the higher genetic risk group, which was defined based on family history of cancer and a polygenic risk score of 400 genetic variants. We further estimated that if all men had adhered to the healthiest lifestyle we could define, that would have prevented or delayed 36% of the early deaths.
MedicalResearch.com: What should readers take away from your report?
Response: Our study indicates that preventive strategies targeted at men at increased genetic risk may reduce the number of early deaths due to prostate cancer. This likely involves early detection and treatment, but potentially also lifestyle interventions.
Although it is possible that men at risk for prostate cancer may receive more specific advice in the future, men should already now be advised to adhere to general components of a healthy lifestyle such as regular physical activity and a diet rich in vegetables and fiber.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Future research should focus on how to best implement genetic testing for prostate cancer. Although tests are commercially available, genetic testing of healthy men is currently not widely implemented and there are challenges around this that needs to be resolved, such as for example maintaining genetic integrity.
Further, current polygenic risk scores are not particularly specific to more aggressive disease, and there is a risk of overdiagnosis of low-risk disease if such scores are used without considering this. Nevertheless, genetic testing of inherited prostate cancer susceptibility shows great promise for improved prostate cancer detection and prevention and is likely the way forward for the field.
Citation:
Plym A, Zhang Y, Stopsack KH, et al. Early Prostate Cancer Deaths Among Men With Higher vs Lower Genetic Risk. JAMA Netw Open. 2024;7(7):e2420034. doi:10.1001/jamanetworkopen.2024.20034