Medical Oncologist
CION Cancer Clinics
HOXB13 mutation: which cancers it affects and how much | CION Cancer Clinics
A HOXB13 fault mainly raises the chance of prostate cancer, and often at a younger age than usual. Links with other cancers have been reported but are not settled. This page explains how strong the prostate link is, why the figures you read online may not fit Indian families, what the result means for men and for women, and what it cannot tell you. At CION Cancer Clinics, our oncologists explain what a gene result means for you and your family, and plan the checks that follow.
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Medically reviewed by Dr. Naresh GunduConsultant Medical Oncologist · MBBS, DNB (Internal Medicine), DM (Medical Oncology, AIIMS) · last reviewed September 2026, next review due September 2027
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On this page
- Which cancers does a HOXB13 fault raise the risk of?
- How strong is the link for each cancer?
- How is one man's own risk worked out?
- What do the risk words on a HOXB13 report mean?
- What does a HOXB13 result mean for a man and for a woman?
- What do families believe about HOXB13 that is not true?
- What can this page not tell you?
- Common questions about HOXB13 and cancer risk
The short answer
Which cancers does a HOXB13 fault raise the risk of?
The one cancer firmly linked to HOXB13 is prostate cancer. A man who carries a harmful change in this gene has a higher chance of prostate cancer than other men, and it is more likely to appear at a younger age. Links with other cancers have been reported, but they are weak and not settled.
How big is the raise in risk?
Doctors call HOXB13 a moderate-risk gene. That puts it below genes like BRCA2, where the effect is large, and well above the ordinary background risk every man has. Published studies give different figures, because they looked at different populations in different ways. What they agree on is the direction: clearly raised, and nowhere near certain.
Why the picture may differ for Indian families
Most of what is known comes from one change, called G84E, which is found mainly in men of northern European ancestry. It is rare in Indian men. Other HOXB13 changes have been found in Asian and African populations, but studies of them are few and small. So the risk estimates you may read online were not built on families like yours.
Does it make the cancer more aggressive?
The clearest pattern is an earlier age at diagnosis and more cases in one family. Whether the cancers themselves behave worse is not clear. Studies disagree, so nobody should assume a carrier's cancer will be more dangerous.
A HOXB13 fault raises the chance of prostate cancer. It does not decide it.Cancer by cancer
How strong is the link for each cancer?
The evidence is strong for one cancer and thin for the rest. That difference shapes what checks a carrier is offered.
Prostate cancer
This is the established link, seen again and again across large studies. It is the reason HOXB13 is on hereditary cancer panels, and the reason carriers are offered earlier prostate checks.
A fault is more likely when
- Prostate cancer was diagnosed young
- Several men on one side were affected
- A father and son both had it
Prostate cancer at a younger age
Carriers tend to be diagnosed earlier than men without the fault. That matters for the timing of checks, because routine advice is built around the average man, not a carrier.
Other cancers: not settled
Some studies have reported small links with bladder, bowel and breast cancer. Others found nothing. These findings are not strong enough to add extra screening, so carriers follow routine advice for these organs.
Tell your doctor about any cancer in the family, even one that does not seem connected.Women who carry it
No clear added cancer risk has been shown for women. A woman can still carry the fault and pass it to a son, which is why her result matters to her brothers and her children.
Not sure whether this applies to you?
Ask an oncologistWorking it out
How is one man's own risk worked out?
Check what kind of change it is
The counsellor first confirms the change is classed as pathogenic, meaning known to raise risk. An uncertain change is not treated as a fault and does not lead to extra checks.
Draw the family tree
Who had prostate cancer, and at what age, on both sides. A strong family history adds to the risk from the gene itself, so two carriers from different families may get different advice.
Look at the rest of the test
Most men are tested on a panel of genes. A second fault, such as in BRCA2, changes the plan far more than HOXB13 alone. Make sure the whole report is read, not only the positive line.
Weigh age and health
Risk builds with age. A man in his thirties and a man already in later life are in very different places, and so is a man with other serious health problems.
Agree a plan with a urologist
The result of all this is a check plan, usually built around a PSA blood test started earlier than for other men. The plan can change as the family history changes.
On your report
What do the risk words on a HOXB13 report mean?
- Moderate-risk gene
- A gene whose faults raise cancer risk clearly but not greatly. Family history carries more weight than it does with high-risk genes.
- Relative risk
- How many times more likely something is for a carrier than for someone without the fault. It says nothing on its own about how common it is.
- Lifetime risk
- The chance of a cancer at some point across a whole life. This is the figure most people actually want, and the hardest to pin down for HOXB13.
- Penetrance
- How often a fault actually leads to cancer across everyone who carries it. For HOXB13 it is well below all carriers.
- G84E
- Shorthand for the most studied HOXB13 change. Your report may name a different one.
- Founder variant
- A change that traces back to one distant ancestor and is common in one community. G84E is a founder variant in northern Europe.
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Side by side
What does a HOXB13 result mean for a man and for a woman?
A man who carries it
A woman who carries it
Prostate checks usually start earlier
No extra checks are added
Routine screening for bowel and other organs
Routine breast, cervical and bowel screening
Each child has a one in two chance of the fault
Each child has the same one in two chance
His brothers and sons gain most from testing
Her brothers and sons gain most from testing
Commonly believed
What do families believe about HOXB13 that is not true?
"HOXB13 is like BRCA, so it raises the risk of many cancers."
BRCA genes repair damage in every cell, so their faults touch several organs. HOXB13 works mainly in the prostate, and that is where its effect is clear.
"A positive result means I will get prostate cancer."
Many carriers never do. The fault raises the chance, and regular checks mean a cancer that does form is more likely to be found while it is small.
"It is a prostate gene, so the women in the family can ignore it."
A daughter has the same one in two chance of carrying it as a son. If she carries it, her own sons can inherit it. Her result matters for the men who come after her.
"My father's cancer came late, so it cannot be genetic."
Carriers can be diagnosed at any age, including later in life. Late diagnosis makes a fault less likely, not impossible. The pattern across the whole family says more than one man's age.
Being straight with you
What can this page not tell you?
It cannot give you a personal risk figure. That number depends on the exact change, your family history and your age, and even then the studies behind it are thinner than for better known genes. What your specific variant means is a question for the counsellor who ordered the test.
It cannot tell you about the tumour itself
This page covers inherited faults, present in every cell from birth. If your oncologist has asked for a test of the tumour to choose treatment, that is a different test with a different purpose. It is covered on our targeted therapy pages.
Who this does not apply to
Most men with prostate cancer do not carry a HOXB13 fault. One older relative with prostate cancer is common and does not, on its own, point to this gene. If that describes your family, testing is unlikely to change anything, and a counsellor will tell you so honestly.
Questions we are asked
Common questions about HOXB13 and cancer risk
Is HOXB13 a high-risk gene like BRCA2?
No. It is usually described as a moderate-risk gene. The raise in prostate cancer risk is real but smaller than with BRCA2, and it does not spread across several organs. That is why the response is earlier prostate checks rather than a wide screening programme.
At what age should a carrier start prostate checks?
Earlier than other men. International guidance suggests carriers start talking to a doctor about PSA testing some years before the usual age. The exact start depends on how young your relatives were at diagnosis, and your urologist sets it with you.
Does HOXB13 cause bladder or bowel cancer?
The evidence is not strong enough to say so. A few studies found small links and others found none. Carriers are advised to follow the routine screening for their age for these organs, and to report symptoms such as blood in the urine or stool promptly, as anyone should.
My father had prostate cancer. Should I be tested for HOXB13?
Not usually on that alone. Testing is worth discussing if he was diagnosed young, if several men in the family were affected, or if a fault is already known. The best first step is often to test your father, if he is willing and able.
Can a woman carry a HOXB13 fault?
Yes. She has the same one in two chance of inheriting it as her brothers. No clear added cancer risk has been shown for women, but she can pass the fault to her sons. Knowing her result helps her sons and brothers decide about testing and checks.
Will a HOXB13 result change my prostate cancer treatment?
Rarely, at present. Treatment is planned on the cancer itself, its stage and its grade. The result matters most for your brothers and sons, who can be tested for your exact fault and start checks earlier if they carry it.
My report says variant of uncertain significance. Am I at risk?
An uncertain result is not a positive result. The laboratory found a change but does not know whether it matters. It should not change your checks or lead to testing of relatives. Ask how you will be told if the change is ever reclassified.
Where can I get counselling in Telugu about this result?
Genetic counselling at CION can be given in Telugu, and family members are welcome to sit in. Bring your report and a note of who in the family had cancer, and at roughly what age. Call the helpline and it will be arranged at a centre near you.
Your Specialists
Meet CION's oncologists. Bring your family history or genetic report to them.
Our medical oncologists see people with a strong family history of cancer, arrange genetic counselling and testing where it fits, and plan the checks that follow.
Medical Oncologist
Dr. C. Raghavendra Reddy
MBBS(Gold Medal), DNB(General Medicine), DM(Medical Oncology)(Gold Medal)
Medical Oncologist
Dr. Bharati Devi Gorantla
MBBS, MD(General Medicine), DM(Medical Oncology)(Adyar,Chennai), ECMO, MRCP SCE(UK)
Medical Oncologist
Dr. Owais Mohammed
MBBS, MD (General Medicine), DrNB (Medical Oncology), ECMO, MRCP SCE (Medical Oncology) (UK)
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Sources
- MedlinePlus Genetics — HOXB13 gene
- National Cancer Institute — Genetics of Prostate Cancer (PDQ) – Health Professional Version
- National Cancer Institute — Genetic Testing for Inherited Cancer Susceptibility Syndromes
- Cancer Research UK — Inherited cancer genes and increased cancer risk
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Talk to us
Not sure what a HOXB13 result means for your family?
Bring the report and a note of who in the family had prostate cancer. A counsellor will explain what it means for you and your relatives, in Telugu if you prefer. One helpline serves every CION centre.