title: Association between family history of prostate cancer and positive biopsies in a Brazilian screening program.
abstract: OBJECTIVE
  To test the association between family history of prostate cancer (FH) and prostate cancer (PCa) risk in a large screening program in Brazil, as no conclusive study has yet investigated this.
  
  
  METHODS
  Between 2004 and 2007, 17,569 men were screened in 231 small municipalities using mobile screening units. Positive FH was defined as any relative having PCa among screened men. Men were biopsied if they had digital rectal examination suggestive of PCa or PSA >4.0 ng/mL or PSA of 2.5-4 ng/mL with percent free PSA ≤ 15 %. We analyzed the association between FH and PCa using multivariable logistic regression in the first screening round of the program.
  
  
  RESULTS
  Positive FH was present in 735 men (4.2 % of total), and they were younger, better educated and more likely to have had previous PCa screening (41.5 vs. 28.5 %; P < 0.001) compared to men with negative FH. FH status did not affect compliance rates in men recommended to undergo biopsy (P = 0.94). In first round, PCa was detected in 3.1 % of screened men (n = 552). In multivariable analysis, positive FH was associated with increased PCa risk (OR = 1.79; 95 % CI, 1.21-2.65; P = 0.003). However, Gleason scores (P = 0.78) or percent of positive cores (P = 0.32) among men with positive biopsies were similar, regardless of FH status.
  
  
  CONCLUSIONS
  In Brazil, men with positive FH were at increased PCa risk, which could not be explained by differential biopsy rates. This finding suggests that FH is also a true PCa risk factor in Brazil, a country with highly diverse population in terms of race, ethnicity, culture and socioeconomic status.
authors: Division of Urologic Surgery, Department of Surgery, Duke University Medical Center (DUMC), Box 2626, Durham, NC, 27710, USA, roberto.muller@dm.duke.edu.
authors: Roberto L
authors: RL
authors: Muller
authors: Eliney F
authors: EF
authors: Faria
authors: Gustavo F
authors: GF
authors: Carvalhal
authors: Rodolfo B
authors: RB
authors: Reis
authors: Edmundo C
authors: EC
authors: Mauad
authors: Andre L
authors: AL
authors: Carvalho
authors: Stephen J
authors: SJ
authors: Freedland
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001938:Brazil; D051517:Digital Rectal Examination; D055088:Early Detection of Cancer / Q000379:methods*; D005192:Family Health; D006801:Humans; D016015:Logistic Models; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D011467:Prostate / Q000473:pathology*; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D017430:Prostate-Specific Antigen