As men age, they often develop lower urinary tract symptoms (LUTS) such as nocturia, urinary frequency, and poor stream, as well as prostate enlargement. LUTS can complicate efforts to accurately diagnose prostate cancers, which also happen more frequently as men get older.
A group of researchers conducted a study to determine how accurately a genetic risk score (GRS) for prostate cancer could identify the disease in men consulting with their general practitioner about LUTS. Their findings were published in the British Journal of Cancer.
The researchers used data from 247 men with white European ancestry from the UK Biobank that was linked to primary care records. Their outcome measure was a prostate cancer diagnosis within 2 years of consultation, and the predictor was a genetic risk score (GRS) of 269 genetic variants for prostate cancer.
The GRS used was associated with predicting prostate cancer in men with symptoms. Results showed that the mean GRS for the 247 men with a prostate cancer diagnosis within 2 years of symptoms was 23.52 (SD, 0.81), compared with 22.92 for the 6468 men who did not receive a prostate cancer diagnosis.
“This study is the first to demonstrate that genetic risk scores can improve the selection of men for suspected prostate cancer investigation in primary care, over and above presenting clinical features,” the researchers reported, noting that any combination of clinical features representing a 3% or higher chance of cancer should be investigated, although that could be lowered to 2%. “The integrated risk model presented in this study could be used to risk stratify mean with LUTS above and below this threshold.”
The study findings show that GRS has the potential to improve the diagnostic pathway of patients with LUTS. Patients with the highest risk could be fast-tracked for additional investigation, the researchers suggested.
The study was limited by its inclusion of only men of white European ancestry, which was the result of a lack of ethnic diversity in the UK Biobank. The researchers reported this as a “substantial limitation” because prostate cancer is twice as likely to occur in black men. In addition, the study cohort included a significant number of younger men, which may affect the predictive power of GRS as integration with age may affect its outcomes.
Green HD, Merriel SW, Oram RA, et al. Applying a genetic risk score for prostate cancer to men with lower urinary tract symptoms in primary care to predict prostate cancer diagnosis: a cohort study in the UK Biobank. Br J Cancer. Published online January 21, 2022. doi:10.1038/s41416-022-01918-z