title: Targeted prostate cancer screening in men with mutations in BRCA1 and BRCA2 detects aggressive prostate cancer: preliminary analysis of the results of the IMPACT study.
abstract: OBJECTIVE
  To evaluate the role of targeted prostate cancer screening in men with BRCA1 or BRCA2 mutations, an international study, IMPACT (Identification of Men with a genetic predisposition to ProstAte Cancer: Targeted screening in BRCA1/2 mutation carriers and controls), was established. This is the first multicentre screening study targeted at men with a known genetic predisposition to prostate cancer. A preliminary analysis of the data is reported.
  
  
  METHODS
  Men aged 40-69 years from families with BRCA1 or BRCA2 mutations were offered annual prostate specific antigen (PSA) testing, and those with PSA > 3 ng/mL, were offered a prostate biopsy. Controls were men age-matched (± 5 years) who were negative for the familial mutation.
  
  
  RESULTS
  In total, 300 men were recruited (205 mutation carriers; 89 BRCA1, 116 BRCA2 and 95 controls) over 33 months. At the baseline screen (year 1), 7.0% (21/300) underwent a prostate biopsy. Prostate cancer was diagnosed in ten individuals, a prevalence of 3.3%. The positive predictive value of PSA screening in this cohort was 47·6% (10/21). One prostate cancer was diagnosed at year 2. Of the 11 prostate cancers diagnosed, nine were in mutation carriers, two in controls, and eight were clinically significant.
  
  
  CONCLUSIONS
  The present study shows that the positive predictive value of PSA screening in BRCA mutation carriers is high and that screening detects clinically significant prostate cancer. These results support the rationale for continued screening in such men.
authors.affiliation: The Institute of Cancer Research, Sutton, Surrey, UK.
authors.forename: Anita V
authors.initials: AV
authors.lastname: Mitra
authors.forename: Elizabeth K
authors.initials: EK
authors.lastname: Bancroft
authors.forename: Yolanda
authors.initials: Y
authors.lastname: Barbachano
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Page
authors.forename: C S
authors.initials: CS
authors.lastname: Foster
authors.forename: C
authors.initials: C
authors.lastname: Jameson
authors.forename: G
authors.initials: G
authors.lastname: Mitchell
authors.forename: G J
authors.initials: GJ
authors.lastname: Lindeman
authors.forename: A
authors.initials: A
authors.lastname: Stapleton
authors.forename: G
authors.initials: G
authors.lastname: Suthers
authors.forename: D G
authors.initials: DG
authors.lastname: Evans
authors.forename: D
authors.initials: D
authors.lastname: Cruger
authors.forename: I
authors.initials: I
authors.lastname: Blanco
authors.forename: C
authors.initials: C
authors.lastname: Mercer
authors.forename: J
authors.initials: J
authors.lastname: Kirk
authors.forename: L
authors.initials: L
authors.lastname: Maehle
authors.forename: S
authors.initials: S
authors.lastname: Hodgson
authors.forename: L
authors.initials: L
authors.lastname: Walker
authors.forename: L
authors.initials: L
authors.lastname: Izatt
authors.forename: F
authors.initials: F
authors.lastname: Douglas
authors.forename: K
authors.initials: K
authors.lastname: Tucker
authors.forename: H
authors.initials: H
authors.lastname: Dorkins
authors.forename: V
authors.initials: V
authors.lastname: Clowes
authors.forename: A
authors.initials: A
authors.lastname: Male
authors.forename: A
authors.initials: A
authors.lastname: Donaldson
authors.forename: C
authors.initials: C
authors.lastname: Brewer
authors.forename: R
authors.initials: R
authors.lastname: Doherty
authors.forename: B
authors.initials: B
authors.lastname: Bulman
authors.forename: P J
authors.initials: PJ
authors.lastname: Osther
authors.forename: M
authors.initials: M
authors.lastname: Salinas
authors.forename: D
authors.initials: D
authors.lastname: Eccles
authors.forename: K
authors.initials: K
authors.lastname: Axcrona
authors.forename: I
authors.initials: I
authors.lastname: Jobson
authors.forename: B
authors.initials: B
authors.lastname: Newcombe
authors.forename: C
authors.initials: C
authors.lastname: Cybulski
authors.forename: W S
authors.initials: WS
authors.lastname: Rubinstein
authors.forename: S
authors.initials: S
authors.lastname: Buys
authors.forename: S
authors.initials: S
authors.lastname: Townshend
authors.forename: E
authors.initials: E
authors.lastname: Friedman
authors.forename: S
authors.initials: S
authors.lastname: Domchek
authors.forename: T
authors.initials: T
authors.lastname: Ramon Y Cajal
authors.forename: A
authors.initials: A
authors.lastname: Spigelman
authors.forename: S H
authors.initials: SH
authors.lastname: Teo
authors.forename: N
authors.initials: N
authors.lastname: Nicolai
authors.forename: N
authors.initials: N
authors.lastname: Aaronson
authors.forename: A
authors.initials: A
authors.lastname: Ardern-Jones
authors.forename: C
authors.initials: C
authors.lastname: Bangma
authors.forename: D
authors.initials: D
authors.lastname: Dearnaley
authors.forename: J
authors.initials: J
authors.lastname: Eyfjord
authors.forename: A
authors.initials: A
authors.lastname: Falconer
authors.forename: H
authors.initials: H
authors.lastname: Grönberg
authors.forename: F
authors.initials: F
authors.lastname: Hamdy
authors.forename: O
authors.initials: O
authors.lastname: Johannsson
authors.forename: V
authors.initials: V
authors.lastname: Khoo
authors.forename: Z
authors.initials: Z
authors.lastname: Kote-Jarai
authors.forename: H
authors.initials: H
authors.lastname: Lilja
authors.forename: J
authors.initials: J
authors.lastname: Lubinski
authors.forename: J
authors.initials: J
authors.lastname: Melia
authors.forename: C
authors.initials: C
authors.lastname: Moynihan
authors.forename: S
authors.initials: S
authors.lastname: Peock
authors.forename: G
authors.initials: G
authors.lastname: Rennert
authors.forename: F
authors.initials: F
authors.lastname: Schröder
authors.forename: P
authors.initials: P
authors.lastname: Sibley
authors.forename: M
authors.initials: M
authors.lastname: Suri
authors.forename: P
authors.initials: P
authors.lastname: Wilson
authors.forename: Y J
authors.initials: YJ
authors.lastname: Bignon
authors.forename: S
authors.initials: S
authors.lastname: Strom
authors.forename: M
authors.initials: M
authors.lastname: Tischkowitz
authors.forename: A
authors.initials: A
authors.lastname: Liljegren
authors.forename: D
authors.initials: D
authors.lastname: Ilencikova
authors.forename: A
authors.initials: A
authors.lastname: Abele
authors.forename: K
authors.initials: K
authors.lastname: Kyriacou
authors.forename: C
authors.initials: C
authors.lastname: van Asperen
authors.forename: L
authors.initials: L
authors.lastname: Kiemeney
authors.forename: D F
authors.initials: DF
authors.lastname: Easton
authors.forename: Rosalind A
authors.initials: RA
authors.lastname: Eeles
mesh_terms: D000328:Adult; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods* / Q000592:standards; D004812:Epidemiologic Methods; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D020022:Genetic Predisposition to Disease / Q000453:epidemiology / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D017430:Prostate-Specific Antigen / Q000097:blood*; D011471:Prostatic Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics
chemical_list: D017430:Prostate-Specific Antigen