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.