by Dr. Hsien-Hsien Lei
Posted February 12, 2008 in DNA Testing, DNA and Disease
The genetic testing market is highly competitive. No sooner does one company launch a first-of-its-kind test than another launches a similar one. In January, Proactive Genomics made available the $300 prostate cancer genetic test, Focus5 Prostate Cancer Risk Test, that examines five SNPs. (Although it’s not clear from their website how consumers can order the test.) Less than a month later, deCODE Diagnostics follows suit with the $500 deCODE PrCa test that analyzes eight SNPs for prostate cancer:
Three on chromosome 8 (8q24)
Two on chromosome 17 (17q12, 17q24.3)
One on chromosome 2 (2p15)
One on chromosome 11 (11q13.3)
One on X-chromosome (Xp11.22)
deCODE states that the relative risk of prostate cancer for those of European ancestry who are homozygous at all eight is 17.6 times higher than the reference group.
About 40% of the population has a genotype combination of the tested markers that have an increased relative risk (>1) over the general population
About 10% of the population has a genotype combination that confer an average two-fold relative risk
About 1% have relative risk above 3
The deCODE PrCa test is available from physicians and medical practitioners. Patients can kick start the process by downloading the test order forms and bringing them to their doctor’s visit.
There is a strong market for prostate cancer testing. Prostate cancer is the second leading cause of cancer-related death in American men. According to the National Cancer Institute, there were almost 220,000 new cases of prostate cancer in 2007 and over 27,000 deaths attributed to the disease. The American Cancer Society recommends screening for men starting at age 50 with men at higher risk receiving screening starting at age 45.
Screening, however, is controversial. Some studies have not observed a decrease in mortality rate from early screening for prostate cancer. Early detection at younger ages may not be particularly useful because prostate cancer develops slowly and would be better left alone until many years down the line. deCODE literature emphasizes that the five-year survival rate among prostate cancer patients is 100 percent due to early detection.
From the Prostate Cancer Foundation:
…there is no unanimous opinion in the medical community regarding the benefits of prostate cancer screening. Those who advocate regular screening believe that finding and treating prostate cancer early offers men more treatment options with potentially fewer side effects. Those who recommend against regular screening note that because most prostate cancers grow very slowly, the side effects of treatment would likely outweigh any benefit that might be derived from detecting the cancer at a stage when it is unlikely to cause problems.
Can prostate cancer be beaten?
- A new genetic test will enable men at high risk to be identified for regular screening
- More accurate blood tests based on a new gene target could mean earlier identification of the disease
- Treatment could be offered to those men with fast-growing, aggressive cancers
- The existing PSA blood test cannot distinguish between a cancerous prostate and a benignly enlarged one
- Even when cancer is diagnosed there is often no way of knowing if it needs treating
- Prostate cancer is unique in that it can be so slow to develop that more men die with it than from it
More on prostate cancer genetic testing from Cancer Genetics.
NB: DNA Direct (for whom I work) partners with deCODE to offer free pre- and post-testing consultation and genetic counselling.
Photo credit: Wellcome Photo Library, Colour artwork of the urinary bladder with its two ureters and also the seminal vesicles and the ampulla of vas, leading to the vas deferens. The prostate gland and its passages are at the base of the bladder in this posterior drawing.
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