Update on IMPACT – Targeted Prostate Cancer Screening in BRCA1 and BRCA2 Mutation Carriers and Men with Lynch Syndrome

Ros Eeles, PhD, FRCP, FRCR, describes interim results from the IMPACT study, showing a recommendation for yearly PSA screening in BRCA2 mutation carriers. Those with gene mutations are more likely to have aggressive disease, almost twice as much as those without. In BRCA2 carriers, positive predictive value of biopsy and PSA was significantly higher, with a younger onset of mutations and higher Gleason scores.

Professor Eeles turns to a small recruitment study of the Lynch Cohort, which showed 85% of MSH2 carriers and 75% of MSH6 carriers had clinically significant disease, while MSH2 and MSH6 non-carriers had no clinically significant disease. The participants had a mean age 52.8 and 81% of participants do not have a strong family history of prostate cancer. As it is still unknown if very early disease could be managed by active surveillance, Professor Eeles suggests data is still needed to support active surveillance and MRI for early-stage disease in these carriers.

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