deCODE ProstateCancer™
A novel test detecting the most comprehensive set of validated genetic risk factors for prostate cancer. The test identifies 6% of men of European descent who are at more than double the average lifetime risk, 12% of African-American men who have between 1.5 fold and threefold increased risk, and 7% of East Asian men who have between two to eightfold increased risk. Test results, along with other risk factors, can help to inform and optimize screening and early detection.
Screening and prevention
How deCODE ProstateCancer™ can help.
Genetic risk and screening
The American Urology Association (AUA) recommends that men 40 and over should be offered baseline assessment for risk of prostate cancer. deCODE ProstateCancer™ is a one time test that measures genetic risk of prostate cancer and can thereby help to establish an individual’s baseline risk. This brings genetic risk into the discussion between men and their physicians regarding whether, when and how frequently to screen for prostate cancer going forward.
Informing the decision to biopsy
Having the most complete picture of individual risk is fundamental to making an informed decision whether to proceed to biopsy. deCODE ProstateCancer™ provides novel information that, together with other risk factors, clinical examination and PSA scores, contributes to a comprehensive risk profile with which to consider the options.
deCODE ProstateCancer™ provides genetic risk information that is of clinical relevance for a significant proportion of men
Approximately 15% of males of European ancestry will receive test results reducing their overall assessed lifetime risk by 50% or more; and about 6% will see their assessed risk more than double. The risk detected by deCODE ProstateCancer™ is therefore of similar impact for men of European ancestry to that conferred by having a family history of the disease. Moreover, this risk is independent of and complements that of other risk factors, including family history.
About 35% of African-Americans males will have results that reduce their overall risk by 20-60% and about 12% of African-American males will have between a 1.5 to threefold (50-200%) increase in their risk of developing prostate cancer. Again, this risk is independent of and complements that of other risk factors, including family history.
Approximately 20% of East Asian men will receive test results that reduces their risk by 50% or more, while almost 8% of East Asian males will have it more than doubled.
Informing patients – telling the complete story
In the wake of a recent debate regarding the effectiveness of prostate cancer screening and treatment (55-56), better risk stratification and well-informed patients are now being placed at the center of the decision-making process. In this model, it is of paramount importance to provide individuals with the most complete and unbiased information regarding their own risk of disease and the potential benefits and risks of early detection and treatment. It is the role of the physician to bring together this information – on family history, PSA measurements, and other factors such as genetic risk – to inform the discussion of whether and how frequently to screen for prostate cancer, and when to proceed to biopsy and prostectomy.
Getting with the guidelines
This information can help doctors to implement the screening guidelines of leading professional organizations. The American Urological Association (AUA) recommends that men 40 years of age or older should be offered a baseline risk assessment and early detection screening for prostate cancer; and men who wish to be screened should have both a prostate-specific antigen (PSA) test and a digital rectal exam (DRE). The AUA believes that a risk assessment at the age of 40, including a baseline PSA measurement contributes to more cost effective prostate cancer screening and prevention. The AUA is also of the opinion that the decision to proceed to prostate biopsy should be based not only on PSA and DRE results, but should take into account multiple factors including free and total PSA, patient age, PSA velocity, PSA density, family history, ethnicity, prior biopsy history and comorbidities.
The American Cancer Society (ACS) recommends that men, working with their physicians, be given the opportunity to make an informed choice about screening, taking into account comprehensive information on the uncertainties, risks and potential benefits. The ACS further suggests that all men 50 years of age and older without known risk factors and who elect to undergo screening should be screened every year for prostate cancer with at least a blood test (PSA) and a rectal exam. ACS recommends that men with risk factors, such as a family history or African ancestry, should start screening earlier, by age 40 or 45.
This content was last reviewed on April 08, 2011.