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Prostate cancer is the fourth leading cause of cancer death among men in Hong Kong, and the incidence and mortality of prostate cancer have been increasing over the past few decades. In 2021, there were 3,038 newly diagnosed cases of prostate cancer in Hong Kong, accounting for 16.0% of all new cancer cases in men. The crude incidence of prostate cancer is 89.8 cases per 100 000 male population, and the age-standardized incidence is 38.5 cases per 100 000 standard population[1]. Although most prostate tumors grow slowly and usually affect people over 65 years of age, certain genetic variants increase the risk of developing prostate cancer.
These include the BRCA1 and BRCA2 genes, which play a key role in preventing cellular errors and inhibiting cancer growth.
What is the BRCA gene?
BRCA1 and BRCA2 are tumor suppressor genes in every cell of your body. These genes provide instructions for making proteins that repair cell damage.
Mutations, or variations, in the BRCA genes may impair their function, making it harder for them to prevent cancer-promoting changes in cells.
How does the BRCA gene affect prostate cancer risk?
About 10% of prostate cancers are associated with inherited gene mutations. BRCA2 mutations significantly increase the risk of inherited prostate cancer.
If you have a BRCA2 mutation, your lifetime risk of developing prostate cancer may be 20% to 40%, or even as high as 60%. In comparison, men without this mutation have a chance of developing prostate cancer of about 16%. Men with BRCA gene mutations are more likely to have more aggressive prostate cancer and to develop prostate cancer before the age of 65. They are also at higher risk of experiencing a recurrence of cancer after treatment and of dying from prostate cancer-related causes.
Genetic testing and early screening
If you have a family history of prostate cancer, please consult your family doctor. Genetic testing can detect BRCA gene mutations. If you are tested to have BRCA genetic mutations, you need to undergo regular physical examinations and early tumor screening, and receive treatment based on your individual situation.
Keep in mind that while BRCA gene mutations increase risk, not everyone with these mutations will develop prostate cancer. Regular screening and informed decision-making are essential to manage risk and promote early detection.
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