Evidence of familial clustering of prostate carcinoma is well documented in many case-control studies.13-24 Three major conclusions can be drawn from these studies. First, estimates of the relative risk of developing prostate cancer are higher in first-degree relatives of prostate cancer cases compared to the general population. This increase of relative risk among relatives of prostate cancer patients has been demonstrated in several ethnic and racial groups, including African Americans, Caucasians, Hispanics, and Asians. Second, the risk of prostate cancer increases with increasing number of affected relatives. For example, in the study conducted by Lesko et al.,23 the odds ratio (OR) was 2.2 for subjects with a family history of prostate cancer in one relative and went up to 3.9 for subjects with a family history of two or more affected relatives. Third, the risk of developing prostate cancer among first- and second-degree relatives is negatively correlated with a decrease in the age at diagnosis of index cases. In one study for men with a relative diagnosed before 65 years of age, the OR of prostate cancer was 4.1 compared to 0.76 for those with a relative diagnosed after age 74.23 Several cohort studies, designed to decrease the recall bias and detection bias inherent in case-control studies have also shown the same trend as seen in case control studies.25-28
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