Targeted Prostate Cancer Screening in Men with BRCA1 or BRCA2 Mutations

The IMPACT study evaluated whether annual prostate-specific antigen (PSA) screening is effective for early detection of prostate

cancer in men with inherited BRCA1 or BRCA2 mutations, which are known to increase cancer risk. The study followed over 3,000 men aged 40–69 across multiple countries, including both mutation carriers and noncarriers, over five rounds of annual PSA testing, with biopsies performed when PSA levels exceeded 3.0 ng/ml. While overall prostate cancer incidence did not differ significantly between carriers and noncarriers, men with BRCA2 mutations had a significantly higher rate of clinically significant (more aggressive) prostate cancer. Additionally , tumors detected in both BRCA1 and BRCA2 carriers were more likely to be high-risk than those in noncarriers. Importantly , no metastatic cases were identified, indicating that screening enabled earlier detection. The findings support routine PSA screening for men with BRCA2 mutations and suggest it should also be considered for those with BRCA1 mutations, as screening improves the detection of more aggressive cancers in these higher-risk groups.

Eur Urol 2026 PMID: 41714267