Is prostate cancer hereditary?

With the popularity of mail-away DNA tests and ancestry reports, people are learning more about what makes them who they are. Learning about your family history can be exciting, but this trend also has people curious about the health risks they may have inherited through family genetics.

For men, one of the biggest health concerns as they age is a prostate cancer diagnosis. Research has found that prostate cancer does appear to have a hereditary component, but that doesn't mean all prostate cancers are hereditary. 

Prostate cancer is a result of genetic mutations in the prostate, but it is unclear if all those mutations are inherited or if some of them are acquired during a lifetime due to exposures to carcinogens. What researchers do know, is that about 5% of all cancers are inherited, 5% are caused by purely environmental factors, and about 90% are a combination of the two, a gene-environment interaction.

To determine which men are more likely to develop prostate cancer, we rely on their known risk factors such as:

• a brother or father with prostate cancer, especially if they were diagnosed younger than age 65, and if a family member has died of prostate cancer.
• Ashkenazi Jewish ancestry.
• being African-American.
• known inherited gene mutations associated with increased cancer risk. The most common are the BRCA1 and BRCA2 genes associated with breast cancer. In addition, Lynch syndrome, an inherited genetic syndrome related to colorectal cancers, is also associated with increased risk for ovarian, bladder and prostate cancer.

Men becoming more aware of their health risks — genetic and environmental — is important because prostate cancer often doesn't present with any symptoms until it is in a very late stage when treatment options are limited. This makes early detection key. 

Early detection for prostate cancer involves a digital rectal exam to palpate the prostate and feel for any abnormal nodules and a PSA blood test. These two tests together are the most effective combination for screening.

If you decide early detection is right for you, guidelines recommend screening start at age 45.  For men at high risk — African-Americans, men with a family history of prostate cancer, particularly in a brother or father who had prostate cancer, or men with a known genetic mutation, screening should begin at age of 40, or 10 years before the earliest prostate cancer case in your family.