title: Impact of family history on prostate cancer mortality in white men undergoing prostate specific antigen based screening.
abstract: OBJECTIVE
  We assessed whether prostate cancer screening would decrease prostate cancer mortality in white men with a family history of prostate cancer.
  
  
  METHODS
  Data from the PLCO cancer screening trial were used to compare the screening and usual care arms in the subset of men with and without a family history of prostate cancer. Univariate and multivariate Cox regression analysis, and log rank analysis of Kaplan-Meier curves were done to examine the data for differences in prostate cancer specific survival.
  
  
  RESULTS
  A total of 65,179 white subjects were included in the prostate specific antigen screening trial, of whom 7,314 (11.2%) were diagnosed with prostate cancer. Only 4,833 white men (7.4%) had a family history of prostate cancer. Those with a positive family history had a significantly higher incidence of prostate cancer (16.9% vs 10.8%) and higher prostate cancer specific mortality (0.56% vs 0.37%, each p <0.01). On multivariate analysis this trended toward significance (HR 1.47, 95% CI 0.98-2.21, p = 0.06). Screening in men with a positive family history also showed a trend toward decreased prostate cancer specific mortality (HR 0.49, 95% CI 0.22-1.1, p = 0.08) and decreased time to death from prostate cancer (log rank p = 0.05).
  
  
  CONCLUSIONS
  White men with a family history of prostate cancer are at increased risk for being diagnosed with and subsequently dying of prostate cancer. Yearly digital rectal examination and prostate specific antigen testing may decrease prostate cancer death in these individuals.
authors: Department of Urology, University of California-San Diego Health System, San Diego, California. Electronic address: mliss008@gmail.com.
authors: Michael A
authors: MA
authors: Liss
authors: State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, People's Republic of China; Department of Genomics and Personalized Medicine Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Haitao
authors: H
authors: Chen
authors: Department of Urology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Sij
authors: S
authors: Hemal
authors: Department of Urology, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Spencer
authors: S
authors: Krane
authors: Department of Urology, University of California-San Diego Health System, San Diego, California.
authors: Christopher J
authors: CJ
authors: Kane
authors: State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, People's Republic of China; Department of Genomics and Personalized Medicine Research, Wake Forest University School of Medicine, Winston-Salem, North Carolina.
authors: Jianfeng
authors: J
authors: Xu
authors: Department of Urology, University of California-San Diego Health System, San Diego, California.
authors: A Karim
authors: AK
authors: Kader
mesh_terms: D000368:Aged; D055088:Early Detection of Cancer; D006801:Humans; D008297:Male; D008875:Middle Aged; D017430:Prostate-Specific Antigen / Q000097:blood; D011471:Prostatic Neoplasms / Q000097:blood / Q000208:ethnology / Q000235:genetics* / Q000401:mortality*; D044465:White People
chemical_list: D017430:Prostate-Specific Antigen
keywords: European continental ancestry group; mass screening; mortality; prostate-specific antigen; prostatic neoplasms