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Aggressive, early-onset prostate cancer linked to genetic variants
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Genetic variants were associated with increased risk for early onset prostate cancer, with patients diagnosed at a younger age exhibiting a greater likelihood of cause-specific mortality than older men, according to a recent meta-analysis.
“Early onset prostate cancer tends to be aggressive, striking down men in the prime of their life,” Kathleen A. Cooney, MD, professor of internal medicine and urology at the University of Michigan, said in a press release. “These fast-growing tumors in young men might be entirely missed by screening because the timeframe is short before they start to show clinical symptoms.”
In an analysis of current literature, Cooney and colleagues characterized the differences between early-onset prostate cancer – diagnosed at or before age 55 – and prostate cancer diagnosed at an older age. In particular, researchers noted that the occurrence of early onset prostate cancer had increased from 5.6 cases per 100,000 person years in 1986 to 32 cases per 100,000 person years in 2008 (95% CI 5.0 to 6.7).
Researchers also cited study results which found that among men diagnosed with stage IV prostate cancer, those aged between 35 and 44 years had a 1.5-fold greater risk of prostate cancer-specific mortality than men aged between 64 and 75 years; prognoses were also found to be worse worse for men over 80.
Additionally, younger men diagnosed with high-grade tumors were 1.4 times more likely to die of prostate cancer than men diagnosed at an older age.
According to analysis results, men in the younger age groups were more likely to have a family history of prostate cancer, and were also more likely to exhibit a greater number of genetic variants linked to increased risk of prostate cancer than older men in genome-wide association studies.
The researchers noted that although efforts are underway to identify the genes responsible for prostate cancer, this has been problematic because the existing loci together account for only a small percentage of the familial clustering that has been reported. This leaves researchers unable to determine whether further prostate cancer genetic variants could exist to explain the ‘missing’ heritability.
“The unexpectedly poor prognosis of advanced stage early onset prostate cancer supports the idea that a new clinical subtype might exist in the subset of men with early onset prostate cancer,” Cooney said. “This subtype is more aggressive and requires more specialty expertise, including genetic sequencing.”
Disclosure: The researchers report no relevant disclosures.
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