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The HOXB13 gene: what it does and why it matters | CION Cancer Clinics
HOXB13 is a gene that helps the prostate grow normally. An inherited fault in it raises a man's chance of prostate cancer, sometimes at a younger age than usual, but it does not make cancer certain. This page explains what the gene normally does, how a fault changes things, who in the family a result matters for, 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
- What does the HOXB13 gene actually do?
- Who does a HOXB13 result matter for?
- How can a HOXB13 fault lead to prostate cancer?
- The words on a HOXB13 report, in plain language
- How is HOXB13 different from the repair genes?
- What this page cannot tell you
- Four things families tell us about HOXB13, and what is true
- Common questions about the HOXB13 gene
The short answer
What does the HOXB13 gene actually do?
HOXB13 is a gene that helps the prostate form and grow normally. A harmful change in it, passed down in families, raises a man's chance of prostate cancer. It belongs to a group of genes that act like master switches before birth, telling cells in the lower body what to become. In adult men it keeps working in the prostate, where it helps control how prostate cells grow and respond to male hormones.
What a fault changes
A harmful change does not simply switch the gene off. The best known fault, called G84E, slightly alters the protein the gene makes, so it is less good at keeping prostate cells in check. Over many years that can make it easier for a prostate cancer to form. It raises risk. It does not decide the outcome.
Why it is not like the BRCA genes
Most inherited cancer genes people have heard of, such as BRCA1 and BRCA2, repair damaged DNA in every cell. HOXB13 does not repair anything. It shapes how one organ grows. That is why its effect is concentrated in the prostate rather than spread across many cancers.
A HOXB13 fault is a statement about prostate cancer risk. It is not a diagnosis.Who it touches
Who does a HOXB13 result matter for?
The same fault means different things depending on who in the family carries it.
Men who already have prostate cancer
A result can explain why the cancer appeared, especially if it came early or runs in the family. Today it rarely changes the treatment itself. Its main value is for the relatives.
Testing is often suggested when
- Prostate cancer was diagnosed young
- Several men on one side had prostate cancer
- A HOXB13 fault is already known in the family
Men who are well
A man who carries the fault has a raised chance of prostate cancer across his life. The usual response is to start prostate checks earlier and repeat them more regularly, planned with a doctor.
Women in the family
Women do not have a prostate, so the main risk this gene carries does not apply to them. Links with other cancers are uncertain. A woman can still carry the fault and pass it to a son.
A daughter's result matters mostly for her sons and brothers.Most families
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.
Not sure whether this applies to you?
Ask an oncologistFrom gene to tumour
How can a HOXB13 fault lead to prostate cancer?
Every man has two copies
One comes from each parent. A man who inherits a fault has one altered copy in every cell of his body from birth. Nothing is wrong yet, and he feels completely well.
The altered protein works less well
In the prostate, the normal protein helps hold cell growth in balance. The altered version does this job less reliably, and the effect shows mainly as a man gets older.
Other changes build up with age
Prostate cells collect further changes over decades. Age, other genes and male hormones all play a part alongside HOXB13.
A cancer may or may not form
In some carriers these steps add up to a prostate cancer, sometimes earlier than usual. Many carriers never develop one. Why two brothers with the same fault can have different lives is not fully understood.
On your report
The words on a HOXB13 report, in plain language
- HOX genes
- A group of genes that guide how the body is laid out before birth. HOXB13 is one of them.
- G84E
- Shorthand for the most studied HOXB13 fault. It describes one small change in the protein the gene makes.
- Pathogenic variant
- A change known to raise cancer risk. Likely pathogenic means the evidence is strong but not yet complete.
- Variant of uncertain significance
- A change the laboratory cannot yet classify. It should not be treated as a positive result.
- Germline
- Present in every cell from birth, so it can be passed on. A fault found only inside a tumour is called somatic.
- Dominant
- One altered copy is enough to raise risk. Each child of a carrier has an even chance of inheriting it.
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Side by side
How is HOXB13 different from the repair genes?
HOXB13
BRCA2 and similar repair genes
Shapes how prostate cells grow
Repairs damaged DNA in every cell
Risk concentrated mainly in the prostate
Risk spread across several cancers
Does not currently change which drugs are used
Can open up specific treatments for advanced cancer
Leads mainly to earlier prostate checks
Leads to a broader screening plan
Being straight with you
What this page cannot tell you
It cannot tell you what your own result means. The exact variant, how it is classified and your family history all shape the answer. What your specific variant means is a question for the counsellor who ordered the test.
The evidence in Indian families is thin
Most of what is known about HOXB13 comes from men of Northern European ancestry, where the G84E fault was first found. Other HOXB13 changes have been reported in Asian families, but studies in Indian men so far are small. Precise risk figures for an Indian family are hard to give, and an honest counsellor will say so.
Who this does not apply to
Most men do not need a HOXB13 test. A father or uncle diagnosed with prostate cancer late in life is common and usually not inherited. Testing is considered when prostate cancer came young, clustered in one family, or when a relative already carries a known fault. It is usually part of a wider panel of genes.
Testing a tumour to choose treatment is a different test. That is covered under targeted therapy.Commonly believed
Four things families tell us about HOXB13, and what is true
"Prostate cancer can only come down from my father's side."
The fault can come from either parent. A mother can carry HOXB13 with no effect on her own health and pass it to her son.
"If I carry it, prostate cancer is certain."
It raises the chance. Many carriers never develop prostate cancer, and those who do are more often found early when checks start sooner.
"A HOXB13 fault means my prostate should be removed."
Removing a healthy prostate is not a recommended response to this gene. The standard approach is earlier and more regular checks, planned with your doctor.
"HOXB13 is a European gene, so Indian families cannot have it."
The best known fault is commonest in European families, but HOXB13 changes have been found in other populations too. Where your family comes from changes how often it is found, not whether it can be.
Questions we are asked
Common questions about the HOXB13 gene
Is HOXB13 the same as a BRCA gene?
No. BRCA genes repair damaged DNA and raise the risk of several cancers. HOXB13 guides how prostate cells grow, and its effect is mainly on prostate cancer. Both can be tested on the same blood sample, often in one panel, but they lead to quite different plans.
Does HOXB13 raise the risk of other cancers?
Some studies have suggested links with other cancers, including bowel and breast cancer, but the findings are inconsistent. At present, prostate cancer is the only cancer where the link is well established. Your counsellor will tell you if newer evidence changes this for your family.
Can a woman carry a HOXB13 fault?
Yes. The gene is shared by men and women, so a woman can inherit the fault and pass it on. Her own cancer risk is not clearly raised by it. Her result matters most for her sons, her brothers and her father.
Does a HOXB13 fault change my prostate cancer treatment?
Usually not, at present. Treatment is planned on the stage and features of the cancer itself. The result matters more for relatives, who can be offered their own test and earlier checks if they carry the same fault.
How is the HOXB13 test done?
From a blood or saliva sample, after a counselling session. HOXB13 is usually one gene within a panel that looks at several genes linked to prostate cancer at the same time. Results go back to the counsellor, who explains them with you.
My report says variant of uncertain significance in HOXB13. What now?
It means the laboratory found a change it cannot yet classify. It is not a positive result and should not change your checks on its own. Ask how you will be told if the classification changes as evidence grows.
Should my sons be tested now?
Prostate checks for carriers start in adult life, so testing usually waits until a son is an adult and can decide for himself. There is nothing to gain from testing a child. Your counsellor can help you plan when and how to raise it.
Can I get HOXB13 testing in Hyderabad?
Gene panels that include HOXB13 are available through laboratories in India, arranged after counselling. Call the CION helpline and describe your family history. Someone will point you to the right clinic for counselling and testing.
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.
Keep reading
Related pages
HOXB13 mutation: which cancers and what riskWhat the raised prostate risk looks like in practiceHOXB13 positive: what happens nextThe first steps after a positive resultSurveillance for HOXB13 carriersHow prostate checks are planned for carriersProstate cancer and when genetic testing is advisedWhether your family history qualifies for a test
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Prostate cancer came young in your family?
Tell us who was diagnosed and at roughly what age. We will tell you honestly whether a genetic referral is worth making, and arrange counselling if it is. One helpline serves every CION centre.