title: Family History and Probability of Prostate Cancer, Differentiated by Risk Category: A Nationwide Population-Based Study.
abstract: Familial prostate cancer risk estimates are inflated by clinically insignificant low-risk cancer, diagnosed after prostate-specific antigen testing. We provide age-specific probabilities of non-low- and high-risk prostate cancer.
  
  
  
  Fifty-one thousand, eight hundred ninety-seven brothers of 32 807 men with prostate cancer were identified in Prostate Cancer data Base Sweden (PCBaSe). Nelson-Aalen estimates with 95% confidence intervals (CIs) were calculated for cumulative, family history-stratified probabilities of any, non-low- (any of Gleason score ≥ 7, prostate-specific antigen [PSA] ≥ 10 ng/mL, T3-4, N1, and/or M1) and high-risk prostate cancer (Gleason score ≥ 8 and/or T3-4 and/or PSA ≥ 20 ng/mL and/or N1 and/or M1).
  
  
  
  The population probability of any prostate cancer was 4.8% (95% CI = 4.8% to 4.9%) at age 65 years and 12.9% (95% CI = 12.8% to 12.9%) at age 75 years, of non-low-risk prostate cancer 2.8% (95% CI = 2.7% to 2.8%) at age 65 years and 8.9% (95% CI = 8.8% to 8.9%) at age 75 years, and of high-risk prostate cancer 1.4% (95% CI = 1.3% to 1.4%) at age 65 years and 5.2% (95% CI = 5.1% to 5.2%) at age 75 years. For men with one affected brother, probabilities of any prostate cancer were 14.9% (95% CI = 14.1% to 15.8%) at age 65 years and 30.3% (95% CI = 29.3% to 31.3%) at age 75 years, of non-low-risk prostate cancer 7.3% (95% CI = 6.7% to 7.9%) at age 65 years and 18.8% (95% CI = 17.9% to 19.6%) at age 75 years, and of high-risk prostate cancer 3.0% (95% CI = 2.6% to 3.4%) at age 65 years and 8.9% (95% CI = 8.2% to 9.5%) at age 75 years. Probabilities were higher for men with a stronger family history. For example, men with two affected brothers had a 13.6% (95% CI = 9.9% to 17.6 %) probability of high-risk cancer at age 75 years.
  
  
  
  The age-specific probabilities of non-low- and high-risk cancer presented here are more informative than relative risks of any prostate cancer and more suitable to use for counseling men with a family history of prostate cancer.
authors.affiliation: Department of Translational Medicine Urology, Division of Urological Cancers, Lund University, Sweden (OB);Department of Urology/CamPARI Clinic, Cambridge University Hospitals, Cambridge, UK (OB);Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden (LD, HG);Department of Urology, Karolinska Institute, Stockholm, Sweden (OA);Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden (PS);Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden (PS). ola.bratt@med.lu.se.
authors.forename: Ola
authors.initials: O
authors.lastname: Bratt
authors.affiliation: Department of Translational Medicine Urology, Division of Urological Cancers, Lund University, Sweden (OB);Department of Urology/CamPARI Clinic, Cambridge University Hospitals, Cambridge, UK (OB);Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden (LD, HG);Department of Urology, Karolinska Institute, Stockholm, Sweden (OA);Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden (PS);Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden (PS).
authors.forename: Linda
authors.initials: L
authors.lastname: Drevin
authors.affiliation: Department of Translational Medicine Urology, Division of Urological Cancers, Lund University, Sweden (OB);Department of Urology/CamPARI Clinic, Cambridge University Hospitals, Cambridge, UK (OB);Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden (LD, HG);Department of Urology, Karolinska Institute, Stockholm, Sweden (OA);Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden (PS);Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden (PS).
authors.forename: Olof
authors.initials: O
authors.lastname: Akre
authors.affiliation: Department of Translational Medicine Urology, Division of Urological Cancers, Lund University, Sweden (OB);Department of Urology/CamPARI Clinic, Cambridge University Hospitals, Cambridge, UK (OB);Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden (LD, HG);Department of Urology, Karolinska Institute, Stockholm, Sweden (OA);Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden (PS);Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden (PS).
authors.forename: Hans
authors.initials: H
authors.lastname: Garmo
authors.affiliation: Department of Translational Medicine Urology, Division of Urological Cancers, Lund University, Sweden (OB);Department of Urology/CamPARI Clinic, Cambridge University Hospitals, Cambridge, UK (OB);Regional Cancer Centre, Uppsala/Örebro, Uppsala University Hospital, Uppsala, Sweden (LD, HG);Department of Urology, Karolinska Institute, Stockholm, Sweden (OA);Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umeå, Sweden (PS);Department of Surgical Sciences, Uppsala University Hospital, Uppsala, Sweden (PS).
authors.forename: Pär
authors.initials: P
authors.lastname: Stattin
mesh_terms: D000367:Age Factors; D000368:Aged; D016001:Confidence Intervals; D006801:Humans; D008297:Male; D060787:Neoplasm Grading; D011336:Probability; D011471:Prostatic Neoplasms / Q000453:epidemiology* / Q000235:genetics* / Q000473:pathology; D018570:Risk Assessment; D035781:Siblings; D013548:Sweden / Q000453:epidemiology