Prostate Cancer
Positive Monogenic Risk
Monogenic risk for Prostate Cancer results from a pathogenic variant in any of the following genes: BRCA1, BRCA2, EPCSM, MLH1, MSH2, MSH6, and PMS2. For participants with monogenic risk, recommendations include:
- Referral to a genetic counselor.
- Consider shared decision-making about prostate-specific antigen (PSA) screening at age 40 and consider screening every year rather than every two years.
- Consider baseline digital rectal exam if PSA testing is done.
- Refer to NCCN management guidelines for individuals with a pathogenic variant in any of the genes listed above.
High PRS
A high PRS is associated with 2 to 4 times increased risk for developing Prostate Cancer relative to men not in the high-risk category. The data is based on populations of African, European, Asian, and Hispanic/Latino descent and validated in populations of African and European descent. Validation information is insufficient or not available for populations of other descent. For participants with a high PRS, recommendations include:
- Consider shared decision-making about prostate-specific antigen (PSA) screening at age 40 and consider screening every year rather than every two years.
- Consider baseline digital rectal exam if PSA testing is done.
Note: For the purpose of shared decision-making, a high PRS poses a risk equivalent to a positive family history of Prostate Cancer.
Positive Family History
A positive family history of Prostate Cancer is defined as first-degree relatives diagnosed with prostate cancer. For participants with a positive family history, recommendations include:
- Consider shared decision-making about prostate specific antigen (PSA) screening at age 40 and consider screening every year rather than every two years.
- Consider baseline digital rectal exam if PSA testing is done.
Note: Patients with a positive family history of Prostate Cancer are at least 2.5 times more likely to develop Prostate Cancer than the average person.