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Screening for Targeted Prostate Cancer “May Benefit Men with Hereditary Syndrome”

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Men who inherit an increased risk of cancer through Lynch Syndrome may benefit from regular, specific tests to detect early signs of prostate cancer, researchers say.

Lynch syndrome increases the risk of several types of cancer, including bowel cancer, affecting 175,000 people in the United Kingdom.

But only 5 percent of those in that state know they have it.

According to a new study, an annual prostate-specific antigen (PSA) test may find cases of prostate cancer in men with the genetic characteristics of Lynch syndrome up to eight times more often than in men without it.

Researchers have found that many cancer cases in men with this syndrome are clinically important, suggesting that targeted screening may save lives.

Scientists at the Cancer Institute (ICR) in London believe that targeted annual screening from age 40 may lead to early diagnosis and treatment of prostate cancer in this high-risk male group. increase.

They also suggest that identifying patients with Lynch syndrome may lead to further treatment for them.

This is because there is increasing evidence that immunotherapy that uses the immune system to attack cancer may be particularly effective in men with these mutations if they have a recurrence of the disease. ..

Ros Eeles, a professor of oncology at ICR and a consultant in clinical oncology and tumor genetics at the Royal Marsden NHS Foundation Trust, is leading the impact study.

She states: “Screening for prostate cancer is not recommended for the general public, but we believe it may benefit some groups of men at high risk of heredity.

“Our new findings show that PSA testing in men with Lynch syndrome is far more likely to pick up life-threatening prostate cancer than the general population.

“We believe that men with a genetic defect that causes Lynch syndrome are more likely to benefit from regular PSA testing from the age of 40.

“Targeted screening has the potential to detect advanced prostate cancer early in men at high hereditary risk, increasing their chances of survival.

“And these men’s cancers are aggressive and likely to be life-threatening, requiring radical treatment.

“These results and evidence from ongoing follow-up work will influence future national and international screening guidelines for men in this group with the goal of early detection of prostate cancer and life-saving potential. I expect to give. “

The new study is part of an international impact study involving 828 men from families with Lynch syndrome at 34 centers in eight different countries.

It aims to assess whether regular PSA tests are an effective way to detect prostate cancer in men with certain genetic changes that increase their risk.

More than 600 men who participated in this study are deficient in the MLH1, MSH2, or MSH6 genes associated with Lynch syndrome.

Researchers are concerned that PSA screening has not been shown to be beneficial and is not recommended for men in the general population, which may lead to overdiagnosis and overtreatment of cases.

However, studies suggest that it may be more promising for men at high genetic risk.

Men in the new study were given a PSA test each year, and men who appeared to have a high PSA were given a biopsy to see if they had prostate cancer.

Researchers have found that an annual PSA test can effectively detect prostate cancer in men who have inherited a mutation in the MSH2 or MSH6 gene.

In this study, men with the MSH2 gene deficiency were eight times more likely to be diagnosed with prostate cancer than non-carriers, averaging 58 years younger than 66 years. understood.

According to researchers, men with MSH2 gene deficiency have more aggressive and potentially life-threatening tumors than in the absence of non-carriers, with 85% showing clinically significant disease. I am.

This suggests that overdiagnosis with MSH2 carriers is unlikely.

On the other hand, MSH6 carriers were diagnosed with an average age of 62 years and 75% had life-threatening or clinically significant tumors.

Researchers are planning an additional five years of follow-up.

This study, published in Lancet Oncology, was funded by Cancer Research UK with additional support from the NIHR Biomedical Research Center and ICR of the Ronald and Ritama Corey Foundation and the Royal Marsden NHS Foundation Trust.

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