NCCN Guidelines



RECOMMEND TESTING FOR ANY PROSTATE CANCER PATIENTS WITH AT LEAST ONE OF THE FOLLOWING:

  • Intraductal histology (tends to be associated with more aggressive disease)
  • Ashkenazi Jewish ancestry
  • 3 or more cancers on the same side of the family (HBOC or Lynch Syndrome type cancers including bile duct, breast, colorectal, endometrial, gastric, kidney, melanoma, ovarian, pancreatic, prostate (but not clinically localized Grade Group 1), small bowel, and/or urothelial cancer)
  • Family history of young (<60) or fatal prostate cancer regardless of pathology or grade
  • T3 or T4 disease
  • Regional or metastatic disease
  • Grade group 4 or 5*
  • PSA > 20ng/ml


GENETIC TESTING SHOULD INCLUDE THE FOLLOWING GENES (Consider NGS Panel Testing):
ATM, BRCA1, BRCA2, CHEK2, HOXB13**, MLH1, MSH2, MSH6, PALB2, and PMS2

HOXB13 Summary Cancer Risk Table

CANCER TYPE GENETIC CANCER RISK
Prostate High Risk

HOXB13 gene Cancer Risk Table

CANCER TYPE AGE RANGE CANCER RISK RISK FOR GENERAL POPULATION *
Prostate To age 80 22%-52% 10.9%

HOXB13 Cancer Risk Management Table

CANCER TYPE AGE RANGE CANCER RISK RISK FOR GENERAL POPULATION *
Prostate Recommend prostate cancer screening. 40 years, or 10 years younger than the earliest prostate cancer diagnosis in the family Annually, or adjusted based on results from first PSA screen