This research paper examines the impact of family history of prostate cancer (FHP) and family history of cancer (FHC) on the risk of disease progression and adverse pathology in patients undergoing active surveillance (AS) for prostate cancer. The study included patients from a single tertiary-care center between 2000 and 2019. Disease progression was defined by an increase in Gleason grade on biopsy, and adverse pathology was determined by upgrading or upstaging at radical prostatectomy (RP).
The study involved 3,211 patients, of whom 21% had FHP, 1% had FHC, and 3% had both. The results showed that FHP was associated with an increased risk of disease progression (HR 1.31), while FHC and having both FHP and FHC were not significantly associated with progression. None of the family history categories were associated with adverse pathology at RP.
The conclusion suggests that despite the association between FHP and increased risk of progression, the clinical significance is unclear due to wide confidence intervals. FHC was not linked to progression risk. Therefore, in the absence of known hereditary cancer syndromes, FHP and/or FHC should not be used as the sole criteria to exclude patients from AS.
