Prostate Cancer

Polygenic risk

People with high polygenic risk scores are 2 to 4 times more likely to get prostate cancer than are people who aren't in the high-risk category.

This estimate is based on data about people of African, Asian, European, and Hispanic or Latino ancestry. Information is lacking or not available for those of other ancestries.

For participants with a high polygenic risk score, recommendations include:

  • Consider shared decision-making about prostate-specific antigen (PSA) screening at age 40.
  • Consider screening every year rather than every two years.
  • Consider a baseline digital rectal exam if PSA testing is done.

For shared decision-making, a high polygenic risk score has similar risk as a family history of prostate cancer.

Monogenic risk

Monogenic risk of prostate cancer is due to a variant in any of these genes:

  • BRCA1.
  • BRCA2.
  • EPCSM.
  • MLH1.
  • MSH2.
  • MSH6.
  • PMS2.

For participants with monogenic risk, recommendations include:

  • Referral to a genetic counselor.
  • Consider shared decision-making about prostate-specific antigen (PSA) screening at age 40.
  • Consider screening every year rather than every two years.
  • Consider a baseline digital rectal exam if PSA testing is done.
  • Refer to National Comprehensive Cancer Network guidelines for people with variants in any of the genes listed above.

Family history

A participant has a family history of prostate cancer if their parent, full sibling or child has been diagnosed with prostate cancer. People with a family history of prostate cancer are at least 2.5 times more likely to get prostate cancer than are people who don't have prostate cancer in their families.

For participants with a family history of prostate cancer, recommendations include:

  • Consider shared decision-making about prostate-specific antigen (PSA) screening at age 40.
  • Consider screening every year rather than every two years.
  • Consider a baseline digital rectal exam if PSA testing is done.