Marie-Pierre Moineau

TARGETED SCREENING FOR PROSTATE CANCER IN HIGH RISK FAMILIES: EARLY ONSET IS A SIGNIFICANT RISK FACTOR FOR DISEASE IN FIRST DEGREE RELATIVES

PURPOSE Targeted screening for prostate cancer in high risk families is generally suggested by ages 40 to 45 years in first degree relatives. We support this concept by reporting higher risk and earlier onset of the disease in these families. MATERIALS AND METHODS We proposed serum prostate specific antigen (PSA) testing in 40 to 70-year-old first degree relatives of 435 patients with prostate cancer treated between July 1994 and June 1997. A previous systematic genealogical analysis allowed us to define the familial prostate cancer status of each patient as sporadic or familial. RESULTS Of the 747 potential candidates 442 (59%) accepted into the study have been screened, including 240 who were 40 to 49 years old (mean age 44.8) and 202 who were 50 to 70 years old (mean age 57.4). Two of the 240 subjects (0.8%) had PSA greater than 4 ng./ml. in the 40 to 49-year-old group. Prostate biopsies were negative in 1 relative but diagnostic for prostate cancer in the other. In the 50 to 70-year-old group 25 of 202 subjects (12.4%) had a PSA of greater than 4 ng./ml. Prostate cancer was diagnosed in 9 individuals (4.5%), 9 had negative biopsy results, 1 died before biopsy and 6 refused biopsy. The proportion of relatives with PSA greater than 4 ng./ml. and prostate cancer detection was not different according to familial status (sporadic or familial) but it was significantly higher in first degree relatives with early onset prostate cancer in the family at ages younger than 65 years (p = 0.037 and 0.012, respectively). CONCLUSIONS Our results emphasize the usefulness of PSA screening in high risk families, including those without obvious hereditary features. Furthermore, early onset prostate cancer is a significant risk factor for prostate cancer in first degree relatives.

PD07-11 PROSTATE CANCER SCREENING IN HIGH RISK FAMILIES. A EIGHT-YEAR PROSPECTIVE PROGRAM IN YOUNG FIRST DEGREE RELATIVES AGED 40-49.

mutation (8%), and 3/62 patients with BRCA2 (5%). Overall,16/24 patients (67%) were surgically treated for their cancer. CONCLUSIONS: Malignancy rates in male BRCA mutation carriers are substantially higher than those reported for the general population in corresponding age groups. Prostate cancer is the most prevalent cancer apparent in up to 8% of patients at a median age of 50 years. Unlike other reports, prostate cancer was prevalent among BRCA1 carriers and not restricted to BRCA2.

Development of medians generators for the calculation of MoM for the first-trimester Down syndrome maternal serum markers.

The Down syndrome risk calculation software, Fast Screen pre I plus, from Thermo Fisher Scientific, converts the First-trimester maternal serum markers concentrations (PAPP-A and hCGβ) into degrees of extreme (DoE). To meet the requirements of the French legislation as well as those of the certified biologists for Down syndrome screening, a conversion tool for DoE into multiple of the median (MoM), intermediate reference value for the screening, was developed. In absence of any median polynomial allowing to obtain MoM easily, the calculations were made first on the basis of the polynomials centiles from the software. The subsequent reviews of the risk algorithms showed the fragility of this approach based on the Gaussian hypothesis. Medians generators, calculated from the data of the Kryptor clubs biologists, were established.