Hereditary prostate cancer: it is necessary to screen from the age of 40!

Prostate cancer is the most common in men. It is rather rare before the age of 50, the majority of cases are detected around the age of 70. Two examinations make it possible to detect it: the digital rectal examination and the dosage of the PSA, the specific antigen of the prostate. This is done on a case-by-case basis. According to a study published in The Lancet Oncology, this screening could be beneficial for men with Lynch syndrome. This genetic disease increases the risk of developing certain cancers, including prostate cancer.

Gene mutations

“PSA screening is not recommended for men in the general populationremind the authors, as it has not been shown to be beneficial and there is concern that it could lead to overdiagnosis and overtreatment of cases that would not have caused significant problems.” They were interested in its interest in the case of men with Lynch syndrome. Their work was carried out thanks to the medical data of more than 800 men, all of them had in their family a person with Lynch syndrome. 600 showed it clinical signs: i.e. a mutation in the MLH1, MSH2 or MSH6 genes All men were offered an annual PSA test, and those whose PSA level was deemed to be high were able to undergo a biopsy to determine if they had prostate cancer.

Eight times more cancers detected

Researchers have found that annual PSA tests can effectively detect prostate cancer in men who have inherited Lynch syndrome. Of 305 men with defects in the MSH2 gene, 4.3% were diagnosed with prostate cancer, compared to only 0.5% among men without the syndrome. In sum, affected men were eight times more likely to be diagnosed with prostate cancer compared to unaffected men. Generally, they were diagnosed around the age of 58, which is earlier than average. In most cases, the tumors were aggressive, even fatal. “This suggests that overdiagnosis in MSH2 carriers is unlikely“, say the researchers. They recommend carrying out tests from the age of 40 for men affected by this syndrome.

Future research on treatments

The scientists intend to continue their work by carrying out a follow-up for five years with these patients, in order to observe the effectiveness of the various treatments. In any case, better screening of men at risk could make it possible to act more quickly on the cancer, without it being at too advanced a stage, and thus better treat patients. This is the case of Paul Cunningham, one of the participants in this research. He was diagnosed with Lynch Syndrome after contracting skin cancer and bowel cancer. During his participation, the researchers discovered prostate cancer. “The doctor said if I hadn’t been in the study they probably would have just kept an eye on me.he says, but thanks to the screening, they were able to spot my cancer earlier.“