Behind the headlines: genetic testing and prostate cancer risk

Genetic testing has a huge part to play in modern medicine. It unlocks the potential to better understand not only the fundamental workings of the human body, but also what goes wrong in a whole host of human diseases. It can give us clues about how to prevent some diseases, and help us choose the best weapons to fight many more. The latter is certainly the case with prostate cancer, where genetics is playing an increasingly important role in guiding treatment decisions after diagnosis. However, the role of genetic testing in prostate cancer prediction is less clear.

The issue of predicting risk has been raised again as the Health Secretary, Matt Hancock, shared his experience of taking a genetic test that revealed an apparent higher risk of prostate cancer.

The genetic tests you can buy to assess your prostate cancer risk vary in how reliable they are and how much evidence there is that they can accurately predict your risk. There’s also no useful guidance about what to do if a genetic test does tell you that you’re at increased risk. This is particularly important as we still don’t have a diagnostic test reliable enough to be used as part of a screening programme for prostate cancer.

• Will a genetic test for prostate cancer save my life?
  The decision to have a genetic test isn’t straightforward. Knowing you have a genetic predisposition to prostate cancer might mean that you monitor your health more closely, so may be diagnosed with an aggressive cancer earlier. On the other hand, it might mean that you spend years worrying about getting a disease that might never develop.
• What genetic tests for prostate cancer are available on the NHS?
  Tests for mutations in the genes BRCA1 and BRCA2 are available on the NHS for men with, or at risk of, prostate cancer. However, you may only be eligible for testing if the faulty gene has already been identified in one of your relatives, or there have been a lot of cases of prostate, breast and/or ovarian cancer in your immediate family. In this case, you would be referred for genetic counselling, before deciding whether or not to have a test.
• What genetic tests are available privately?
  There are a number of tests available to purchase. Some of these claim to assess prostate cancer risk specifically, others include prostate cancer among a number of diseases they test for. However, these tests vary in how reliable they are and how much evidence there is that they can accurately predict your risk. We don’t recommend investing in DNA tests if you’re concerned about your risk of prostate cancer. 

Speak to your GP if you’re worried about prostate cancer

While genetic testing for prostate cancer is available privately, we don’t recommend investing in DNA tests as a first step for men concerned about their risk of prostate cancer. Instead, if you’re worried about this speak directly to your GP, or call our Specialist Nurses on 0800 074 8383.

You are at increased risk of prostate cancer if you’re a man over the age of 50, if you’re black, and if your father or brother has had the disease.

What we need to do urgently is improve methods of testing for the disease so prostate cancers that need treating are diagnosed early and accurately. This is a big priority for us, and we’re investing millions of pounds into research to make it happen. You can read more about some of the research we’re funding to improve prostate cancer diagnosis on the research pages of our website.

We are also working hard to help health care professionals use current tests, such as the PSA blood test and multiparametric MRI scanning, more consistently and to their best effect.