TOPLINE:

Men whose fathers diagnosed with prostate cancer at an early age faced a fourfold higher risk for early-onset prostate cancer, with a particularly elevated risk for high Gleason score disease. Also, having a father with high Gleason score cancer more than doubled the risk for aggressive prostate cancer.

METHODOLOGY:

• Researchers conducted a population-based cohort study of 25,287 Swedish men (median age at the start of follow-up, 35 years) whose fathers were diagnosed with prostate cancer between 1998 and 2005.
• The analysis categorised fathers on the basis of Gleason scores: those with low (≤ 6; 60%), intermediate (7; 27%), and high (≥ 8; 13%) scores.
• The overall prostate cancer incidence in participants was assessed by following them from their father's prostate cancer diagnosis until their own prostate cancer diagnosis, death, or December 31, 2020, whichever occurred first.
• A Gleason score (≥ 8) was also measured as a separate outcome to assess the risk for high-grade disease.

TAKEAWAY:

• Overall, 2.5% of men (median age at the end of follow-up, 52 years) were diagnosed with prostate cancer at follow-up (median time, 17 years), with a threefold higher incidence than the expected number (standardised incidence ratio [SIR], 3.2; 95% CI, 2.9-3.4).
• Men with fathers diagnosed with prostate cancer at an early stage (age < 65 years) showed a fourfold higher overall risk than expected (SIR, 4.3; 95% CI, 3.8-5.0).
• Sons of fathers with a high Gleason score had a stronger association with prostate cancer, with high scores for themselves (SIR, 2.6; 95% CI, 1.1-5.1).
• The combination of early age and a high Gleason score in fathers was associated with an increased risk for a high Gleason score in sons (SIR, 4.7; 95% CI, 0.94-13.7).

IN PRACTICE:

"In this population-based study, men whose fathers had been diagnosed with prostate cancer at a young age had an overall four-fold increase in risk of early onset prostate cancer, and particularly an increased risk of high Gleason score cancer. A high Gleason score in the father was also associated with a high Gleason score in the son," the authors wrote. "The family history of prostate cancer, including the father's age at diagnosis and his prostate cancer characteristics, should be considered when counseling men on prostate cancer screening and diagnostic strategies," they added.

SOURCE:

This study was led by E. Lin, Department of Surgical Sciences, Uppsala University, Uppsala, Sweden. It was published online on September 09, 2025, in the International Journal of Cancer.

LIMITATIONS:

T he median age of sons at the end of follow-up was only 52 years, limiting the findings to early-onset prostate cancer rather than lifetime risks. Additionally, changes in the Gleason scoring system over time resulted in grade migration, potentially affecting comparisons between risk categories.

DISCLOSURES:

This study was funded by the Swedish Research Council, Swedish Cancer Society, Region Uppsala, and Uppsala University. The authors declared having no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.