Hereditary Prostate Cancer

Testing with the Hereditary Prostate Cancer Panel may be appropriate if your patient’s individual and/or family history is suggestive of a hereditary predisposition to prostate cancer. Recent updates to national guidelines can assist with identifying patients at risk for hereditary prostate cancer.

If there is a personal history of prostate cancer:

• Clinically high-or very-high localized risk (T3 or higher, grade group 4 or higher, PSA ≥ 20 ng/mL)
• Regional (Any T, N1, M0) or metastatic (Any T, Any N, M1), diagnosed at any age
• Gleason score ≥7, particularly with family history of prostate or other related cancer(s)
• Intraductal histology
• Ashkenazi Jewish ancestry
• Somatic tumor testing showing one of the following:
• Abnormal MSI/IHC tumor testing indicating mismatch repair deficiency
• Abnormal prostate tumor sequencing showing a variant in a gene associated with hereditary prostate cancer
• Diagnosed <60 years of age, particularly with family history of prostate or other related cancer(s)
• Diagnosed >60 years of age AND
• A personal history of a second related cancer in the same individual OR
• A father, brother, or ≥ 2 first, second, or third-degree relatives on the same side of the family with prostate cancer (diagnosed <60 years of age) or other related cancer(s)

If there is not a personal history of prostate cancer:

• A first, second, or third-degree relative meeting one of the above criteria
• A known pathogenic variant for hereditary cancer in a blood relative

The panel consists of 16 genes associated with an increased risk for prostate and other cancers.

Genes tested for in this panel include: ATM, BRCA1, BRCA2, BRIP1, CHEK2, EPCAM, HOXB13, MLH1, MSH2, MSH6, NBN, PALB2, PMS2, RAD51C, RAD51D, and TP53.