Polygenic Risk Scores for Prostate Cancer: Informing Prevention or Therapy
Menée auprès de 1 220 patients bénéficiant d'une surveillance active pour un cancer de la prostate (âge médian : 63 ans ; durée médiane de suivi : 5,3 ans), cette étude évalue l'association entre un système de score, basé sur la présence de variants constitutionnels, et le risque d'évolution de la tumeur
The prevalence of prostate cancer reaches between 30% and 50% in autopsy studies among men who died from other causes. With this large occult disease burden, it is uncontroversial that we do not need tools to identify all men whose prostates harbor undiagnosed cancer. Instead, we need to prevent those cancers that would metastasize and cause symptoms or we need tools to detect and treat them early. A parallel task is to spare men whose cancer would remain indolent from the toxic effects, distress, and cost of unnecessary treatment. To accomplish the latter task, one approach is to reduce diagnoses of low-risk prostate cancer, such as by limiting prostate-specific antigen screening or by reclassifying low-risk Gleason score 6 cancers as cancer precursors. Another approach is to postpone treatment if a cancer diagnosis was not avoided in the first place, ie, active surveillance.
JAMA Oncology , éditorial, 2023