Prostate cancer early detection practices among men with a family history of disease.

OBJECTIVES: Genetic studies of familial prostate cancer, which is often asymptomatic until advanced stages, rely on correct designation of affection status. In this pilot study, we set out to determine the proportion of unaffected men whose families are participating in a study of hereditary prostate cancer who have been tested for prostate cancer with serum prostate-specific antigen (PSA) measurement and digital rectal examination (DRE).

METHODS: Participants were identified from the University of Michigan Prostate Cancer Genetics Project, a family-based study of inherited prostate cancer susceptibility. Of the 141 eligible affected and unaffected sons of men with prostate cancer, 124 (88%) completed a mailed questionnaire regarding serum PSA testing and DRE history.

RESULTS: Among unaffected men, 95% reported ever having had a PSA test, and 97% ever having had a DRE, with most initial tests occurring between the ages of 40 and 60 years. No significant difference in the mean age at first PSA test or DRE between the affected and unaffected men was observed. Affected men were significantly more likely than unaffected men to have a first PSA level greater than 2.5 ng/mL (P = 0.006), but not greater than 4.0 ng/mL (P = 0.614).

CONCLUSIONS: Most men with a family history of prostate cancer are undergoing early detection testing. The differences in early detection testing practices do not appear to account for the difference in affection status among the sons of men with prostate cancer.