title: Incorporation of detailed family history from the Swedish Family Cancer Database into the PCPT risk calculator.
abstract: OBJECTIVE
  A detailed family history provides an inexpensive alternative to genetic profiling for individual risk assessment. We updated the PCPT Risk Calculator to include detailed family histories.
  
  
  METHODS
  The study included 55,168 prostate cancer cases and 638,218 controls from the Swedish Family Cancer Database who were 55 years old or older in 1999 and had at least 1 male first-degree relative 40 years old or older and 1 female first-degree relative 30 years old or older. Likelihood ratios, calculated as the ratio of risk of observing a specific family history pattern in a prostate cancer case compared to a control, were used to update the PCPT Risk Calculator.
  
  
  RESULTS
  Having at least 1 relative with prostate cancer increased the risk of prostate cancer. The likelihood ratio was 1.63 for 1 first-degree relative 60 years old or older at diagnosis (10.1% of cancer cases vs 6.2% of controls), 2.47 if the relative was younger than 60 years (1.5% vs 0.6%), 3.46 for 2 or more relatives 60 years old or older (1.2% vs 0.3%) and 5.68 for 2 or more relatives younger than 60 years (0.05% vs 0.009%). Among men with no diagnosed first-degree relatives the likelihood ratio was 1.09 for 1 or more second-degree relatives diagnosed with prostate cancer (12.7% vs 11.7%). Additional first-degree relatives with breast cancer, or first-degree or second-degree relatives with prostate cancer compounded these risks.
  
  
  CONCLUSIONS
  A detailed family history is an independent predictor of prostate cancer compared to commonly used risk factors. It should be incorporated into decision making for biopsy. Compared with other costly biomarkers it is inexpensive and universally available.
authors.affiliation: Departments of Life Sciences and Mathematics, Technical University Munich, Munich, Germany.
authors.forename: Sonja
authors.initials: S
authors.lastname: Grill
authors.affiliation: Section of Surgery, Durham Veterans Affairs Hospital and Department of Surgery (Urology) and Pathology, Duke University, Durham, North Carolina.
authors.forename: Mahdi
authors.initials: M
authors.lastname: Fallah
authors.affiliation: Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Department of Cellular and Structural Biology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Robin J
authors.initials: RJ
authors.lastname: Leach
authors.affiliation: Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas.
authors.forename: Ian M
authors.initials: IM
authors.lastname: Thompson
authors.affiliation: Section of Surgery, Durham Veterans Affairs Hospital and Department of Surgery (Urology) and Pathology, Duke University, Durham, North Carolina.
authors.forename: Stephen
authors.initials: S
authors.lastname: Freedland
authors.affiliation: Division of Molecular Genetic Epidemiology, German Cancer Research Centre, Heidelberg, Germany; Center for Primary Health Care Research, Lund University, Malmö, Sweden.
authors.forename: Kari
authors.initials: K
authors.lastname: Hemminki
authors.affiliation: Departments of Life Sciences and Mathematics, Technical University Munich, Munich, Germany; Department of Urology, University of Texas Health Science Center at San Antonio, San Antonio, Texas; Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas. Electronic address: ankerst@uthscsa.edu.
authors.forename: Donna P
authors.initials: DP
authors.lastname: Ankerst
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000235:genetics*; D016208:Databases, Factual; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000235:genetics*; D018570:Risk Assessment / Q000379:methods*; D013548:Sweden
keywords: biopsy; breast neoplasms; family; likelihood functions; prostatic neoplasms