01 Epidemiology and Etiology

Question 1

Epidemiology of PCa

Answer 1

2nd most commonly diagnosed cancer in men, estimated 1.4 million diagnoses worldwide in 2020

Question 2

Etiology of prostate cancer: Family history/hereditary PCa

Answer 2

Only a small subpopulation of men with PCa have true hereditary disease. Hereditary PCa (HPCa) is associated with a 6-7 year earlier disease onset

Question 3

Germline mutations and PCa

Answer 3

Pathogenic variants were most commonly identified in BRCA2 (4.5%), CHEK2 (2.2%), ATM (1.8%), and BRCA1

Question 4

BRCA1/2 mutations in PCa

Answer 4

more frequently associated with ISUP > 4, T3/T4 stage, nodal involvement, and metastases at diagnosis than PCa in non-carriers

Question 5

BRCA2 (breast cancer gene) in PCa

Answer 5

in 12 % of men with metastatic PCa; independent predictor of metastases and worse PCa-specific survival

Question 6

ATM (ataxia telangiectasia mutated) gene in PCa

Answer 6

higher rates of lethal PCa among mutation carriers

Question 7

HOXB13 (homeobox B13)

Answer 7

significantly higher PSA at diagnosis, higher Gleason and higher incidence of positive surgical margins than non-carriers

Question 8

Risk factors in PCa

Answer 8

metabolic syndrome, HTN and waist circumference > 102 cm, decreased risk of PCa in statin/metformin users

Question 9

Risk factors in PCa: 5-alpha-reductase inhibitors

Answer 9

5-ARIs have the potential of delaying the development of PCa; this must be weighed against the potential small increased risk of high-grade PCas