Men with mutations in the breast cancer genes BRCA1 and BRCA2 have a higher risk of developing prostate cancer than men who don't carry these genetic mutations. IMPACT is an international study evaluating the use of targeted prostate cancer screening in men with BRCA1/2 mutations. The researchers recently reported the first year's screening results.
All study subjects were 40-69 years of age. Of the 2,481 men in the study, 791 were BRCA1 carriers and 731 were BRCA2 carriers. The biopsy threshold was PSA >3 ng/ml.
Fifty-nine men were diagnosed with prostate cancer (18 BRCA1 carriers and 24 BRCA2 carriers), and 66% of the cancers were intermediate or high-risk. The positive predictive value for biopsy in BRCA2 carriers was 48% - double the value reported in population screening studies. There was a significant difference in detecting intermediate- or high-risk disease in BRCA2 carriers.
The early results from the IMPACT study suggested that targeting screening at men with BRCA mutations could result in the finding the tumors that are more likely to require treatment.
Eur Urol. 2014 Sep;66(3):489-99.