Men with the 'Angelia Jolie gene' should get annual prostate cancer checks, experts say
Men with the ‘Angelia Jolie gene’ should be given annual prostate cancer checks in a bid to find early signs of the disease, leading scientists have said.Experts at the Institute of Cancer Research said men with with BRCA1 and BRCA2 gene mutations are at such high risk they would benefit from screening.The London-based team has been working to understand who is at highest risk of prostate disease and could therefore benefit from targeted checks.It comes as the Daily Mail is campaigning to end needless prostate cancer deaths and for a national prostate cancer screening programme, initially for high risk men.The UK National Screening Committee, which advises the government on which screening programmes to offer, is currently considering recent developments around prostate cancer diagnosis and is due to report its findings later this year.BRCA gene mutations are linked to a higher chance of developing prostate cancer at a younger age and in a more aggressive form.Jolie, who won an Oscar for her role in Girl, Interrupted, had her breasts and ovaries removed after her mother died of ovarian cancer and she learned she had a ‘faulty’ BRCA1 gene, which put her at increased risk of breast and ovarian cancer.Of 100 men with a BRCA2 variant, for example, between 21 and 35 of them will develop prostate cancer before the age of 80, research has found. Blood sample tube for prostate cancer PSA testBack in 2019, the ICR team said men with BRCA2 mutations have such a high risk of aggressive prostate cancers that they should be offered annual PSA testing.Now, their latest study findings, presented at the European Society for Medical Oncology (ESMO) Congress in Berlin, suggest men with BRCA1 mutations should also be offered an annual PSA test, which looks for a marker of the disease in a blood sample.The Impact study, which is funded by Cancer Research UK, the ICR and others, assessed the potential benefits of PSA testing in men with BRCA1 and BRCA2 mutations at 65 centres in 20 different countries around the world.It found that men with the BRCA1 genetic fault were more than three times as likely to have aggressive prostate cancers compared with people without the fault.The study found there was no difference in age of diagnosis, or the risk of developing prostate cancer, for BRCA1 carriers compared with non-carriers.The new results also point to the risk of prostate cancer in BRCA2 carriers being more than double than in non-carriers, from 1.4 per cent to 3.1 per cent.Meanwhile, the average age of diagnosis is 60 for carriers, compared with 65 for non-carriers.Nine in ten men diagnosed with prostate cancer in its early stages are still alive ten years later but this falls to fewer than one in five if caught late, once it has spread around the body.The ICR team said that while more accurate prostate cancer tests – such as a saliva test to detect genetic risk of cancer – are being trialled, targeted screening using a PSA test for those at highest risk could significantly improve early detection of the disease.The scientists are also calling for guidance to be updated so that both BRCA1 and BRCA2 carriers can receive annual PSA testing.Ros Eeles, professor of oncogenetics at the ICR, who led the study, said: ‘Our research shows that men with BRCA1 and BRCA2 mutations face a significantly higher risk of aggressive prostate cancer.‘Until more accurate diagnostic tests become available, targeted PSA screening in this high-risk group could detect these cancers earlier, when treatment is more effective.‘We are urging regulatory bodies to act on the evidence and update current guidance so that all men from 40 years with a BRCA1 or BRCA2 mutation are offered annual PSA testing.‘We are expecting an update to this guidance soon, and we hope to see the inclusion of BRCA carriers in any targeted screening programme, to give these men more control over their health and improve timely diagnosis.’The study offered annual PSA testing to more than 3,000 men for five years.Prostate cancer is the most common cancer in men, with around 63,000 diagnoses and 12,000 deaths each year in the UK.Amy Rylance, assistant director of health improvement at Prostate Cancer UK, said: ‘These exciting findings confirm that annual PSA blood tests would enable men with the BRCA gene variant to find aggressive prostate cancers at an earlier, curable stage.‘It's important evidence that men at the highest risk of this disease would benefit from screening.‘Three years ago, Prostate Cancer UK submitted evidence to the UK National Screening Committee that made the case for screening men with a family history of prostate cancer and Black men - we await their decision.’Rishi Sunak this week said prostate cancer screening would save thousands of lives a year and have a 'generational impact' on men's health.The former Conservative prime minister stood alongside Labour's deputy prime minister David Lammy as they called for targeted checks for men at highest risk of the disease.The cross-party show of support came at the parliamentary launch of a Prostate Cancer Research report showing such a programme would cost the NHS just £18 per patient.
