Prostate Cancer: Risk and Early Detection

Prostate cancer is one of the most common cancers affecting men worldwide. Each year, Prostate Cancer Day provides us with an opportunity to reflect on the importance of early detection and the innovations available that allow for more effective diagnosis of this pathology.

What is Prostate Cancer?

The prostate is a gland exclusive to males, located under the bladder and in front of the rectum. Its main function is to produce seminal fluid, which nourishes and transports sperm. Prostate cancer occurs when cells in the prostate begin to grow in an uncontrolled manner. Although in its early stages it may not present symptoms, as it progresses, it can cause urinary problems, pelvic pain and in more advanced stages, bone pain and other serious symptoms.

Incidence and Population Risk

Prostate cancer is the second most common cancer among men, after lung cancer. According to WHO, more than 1.3 million new cases are diagnosed each year worldwide. The incidence varies significantly by region, being highest in North America, Western Europe and Australia. However, in Spain alone, the predicted incidence for 2024 has increased to 30,316 new cases.

This type of cancer is one of the tumors that tends to occur at older ages, being diagnosed generally after 65 years of age and with a higher incidence between 70-75 years of age, while for those under 50 years of age the incidence tends to be approximately 1%.

The origin or causes of prostate cancer are still largely unknown and are the subject of study. However, some factors that increase the likelihood of developing it are known. Some risk factors include:

• Age: The risk tends to increase significantly after the age of 50.
• Ethnicity: This type of cancer is more common in African-American men and they are also more likely to develop it at a younger age.
• Diet and lifestyle: Several studies have linked certain dietary behaviors as a risk factor, for example, the intake of saturated animal fats, red meat, dairy products with high calcium content, etc.
• Family history and genetic factors: At least 20% of patients with this cancer have a family history. Inherited genetic history increases the risk when high penetrance genetic alleles are inherited.

From a blood or saliva sample, the patient’s DNA is analyzed to identify genetic variants associated with prostate cancer. These variants are combined to generate a total score that indicates the relative risk of developing the disease.

Several studies have linked hundreds of common genetic polymorphisms associated with the risk of developing prostate cancer and it is currently estimated that these variants explain between 28-33% of the familial risk of prostate cancer.

Some of the advantages of using PRS as a prevention tool include:

• Personalization of screening: PRS could help explain genetic risk in patients who do not have mutations in prostate cancer-related gene panels. 
• Reduction of overdiagnosis: By assessing genetic risk, it improves the predictive value of PSA testing, which can be elevated by other causes such as benign prostatic hyperplasia.
• Prevention and management: Knowing the genetic risk provides additional information to the specialist for a more precise evaluation of the patient’s risk with which to design a more adequate medical management.

PRS is an innovative and promising tool for risk estimation of common diseases, which implies an advantage in risk factor assessment in clinical practice. The clinical implementation of PRS for prostate cancer requires the integration of genetic testing with current screening methods to provide a comprehensive risk assessment.

From Veritas, we offer myHealthScore, the polygenic risk genetic test with which we can know if we have an elevated risk of presenting different multifactorial diseases such as prostate cancer. If you want more information, do not hesitate to contact us.