title: Personalized prostate cancer screening among men with high risk genetic predisposition- study protocol for a prospective cohort study.
abstract: BACKGROUND
  Prostate cancer screening among the general population is highly debatable. Nevertheless, screening among high-risk groups is appealing. Prior data suggests that men carrying mutations in the BRCA1& 2 genes may be at increased risk of developing prostate cancer. Additionally, they appear to develop prostate cancer at a younger age and with a more aggressive course. However, prior studies did not systematically perform prostate biopsies and thus cannot determine the true prevalence of prostate cancer in this population.
  
  
  METHODS
  This will be a prospective diagnostic trial of screening for prostate cancer among men with genetic predisposition. The target population is males (40-70 year old) carrying a BRCA1 and/or BRCA2 germ line mutation. They will be identified via our Genetic counseling unit. All men after signing an informed consent will undergo the following tests: PSA, free to total PSA, MRI of prostate and prostate biopsy. The primary endpoint will be to estimate the prevalence, stage and grade of prostate cancer in this population. Additionally, the study aims to estimate the impact of these germ line mutations on benign prostatic hyperplasia. Furthermore, this study aims to create a bio-bank of tissue, urine and serum of this unique cohort for future investigations. Finally, this study will identify an inception cohort for future interventional studies of primary and secondary prevention.
  
  
  CONCLUSIONS
  The proposed research is highly translational and focuses not only on the clinical results, but on the future specimens that will be used to advance our understanding of prostate cancer patho-physiology. Most importantly, these high-risk germ-line mutation carriers are ideal candidates for primary and secondary prevention initiatives.
  
  
  BACKGROUND
  ClinicalTrials.gov: NCT02053805.
authors.affiliation: Division of Urology, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel. sdmargel@gmail.com.
authors.forename: David
authors.initials: D
authors.lastname: Margel
authors.forename: Ofer
authors.initials: O
authors.lastname: Benjaminov
authors.forename: Rachel
authors.initials: R
authors.lastname: Ozalvo
authors.forename: Liat
authors.initials: L
authors.lastname: Shavit Grievink
authors.forename: Inbal
authors.initials: I
authors.lastname: Kedar
authors.forename: Rinat
authors.initials: R
authors.lastname: Yerushalmi
authors.forename: Irit
authors.initials: I
authors.lastname: Ben-Aharon
authors.forename: Victoria
authors.initials: V
authors.lastname: Neiman
authors.forename: Ofer
authors.initials: O
authors.lastname: Yossepowitch
authors.forename: Daniel
authors.initials: D
authors.lastname: Kedar
authors.forename: Zohar
authors.initials: Z
authors.lastname: Levy
authors.forename: Mordechai
authors.initials: M
authors.lastname: Shohat
authors.forename: Baruch
authors.initials: B
authors.lastname: Brenner
authors.forename: Jack
authors.initials: J
authors.lastname: Baniel
authors.forename: Eli
authors.initials: E
authors.lastname: Rosenbaum
mesh_terms: D000328:Adult; D000368:Aged; D019313:BRCA1 Protein / Q000235:genetics*; D024682:BRCA2 Protein / Q000235:genetics*; D018070:Biological Specimen Banks / Q000592:standards; D055088:Early Detection of Cancer / Q000379:methods*; D020022:Genetic Predisposition to Disease; D018095:Germ-Line Mutation; D006801:Humans; D008297:Male; D008875:Middle Aged; D057285:Precision Medicine; D011446:Prospective Studies; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000175:diagnosis* / Q000235:genetics / Q000473:pathology
chemical_list: D019313:BRCA1 Protein; C492913:BRCA1 protein, human; D024682:BRCA2 Protein; C551750:BRCA2 protein, human; D017430:Prostate-Specific Antigen