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Which genes raise the risk of prostate cancer? | CION Cancer Clinics
BRCA2 is the gene most clearly linked to inherited prostate cancer, especially cancer that starts younger or behaves aggressively. HOXB13, the Lynch syndrome genes, ATM, CHEK2, BRCA1 and PALB2 add smaller or less certain rises. This page goes through each gene in plain language, what the evidence actually shows, and why the answer matters for treatment as well as for the family. At CION Cancer Clinics, our oncologists plan screening and care for families with an inherited cancer syndrome, explained in plain words.
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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 genes raise the risk of prostate cancer?
- What each gene means, in plain terms
- Who gets tested, and how it happens
- The words you will meet, in plain language
- A blood gene test and a tumour gene test are not the same
- Four things men tell us, and what is actually true
- What this page cannot tell you
- Common questions about prostate cancer genes
The short answer
Which genes raise the risk of prostate cancer?
BRCA2 is the gene most clearly linked to inherited prostate cancer, especially cancer that appears younger or behaves aggressively. HOXB13, the Lynch syndrome genes, ATM, CHEK2, BRCA1 and PALB2 also raise the risk, but by smaller amounts or with less certain evidence. Most prostate cancer, though, is not caused by any single inherited gene.
BRCA2 stands apart
Of all the genes studied, BRCA2 has the strongest and most consistent evidence. Men who carry it are more likely to develop prostate cancer, to develop it earlier, and to have a form that grows and spreads faster. It is also the gene most likely to change treatment if the cancer spreads.
The others raise risk less, or the evidence is thinner
For HOXB13 the link is real, but most of the research comes from families of European ancestry and little is known about Indian men. For the Lynch genes the rise is modest and clearest with MSH2. For ATM, CHEK2, BRCA1 and PALB2, studies so far are smaller, and estimates of how much the risk rises vary from one study to the next.
Why the gene name matters beyond you
Several of these genes matter for relatives in ways that have nothing to do with the prostate. A BRCA2 fault in a father can mean a raised breast and ovarian cancer risk for his daughters. A Lynch fault can mean bowel and womb cancer risk for his sisters. That is why a result is shared with the family, and why the counsellor asks about every side of the family tree.
Most men with prostate cancer carry none of these faults.Gene by gene
What each gene means, in plain terms
A multi-gene panel usually tests all of these together. These are the ones most often found in men with prostate cancer.
BRCA2
A DNA repair gene. Faults raise the risk of prostate cancer that comes younger and grows faster, and also of male breast, pancreatic and ovarian cancer in the family.
Usually leads to
- Earlier PSA checks for male carriers
- Breast screening for female relatives
- Treatment options if cancer spreads
HOXB13
A gene that guides how the prostate develops. One particular fault raises the risk of prostate cancer, often at a younger age. It is not known to raise the risk of other cancers much.
The Lynch genes
MLH1, MSH2, MSH6 and PMS2 repair copying errors in DNA. They mainly raise bowel and womb cancer risk, with a modest rise in prostate risk, most clearly with MSH2.
For men with Lynch syndrome, bowel screening is the priority.ATM, CHEK2, BRCA1 and PALB2
Each is linked to some rise in prostate risk. The evidence is thinner than for BRCA2, so screening advice for male carriers is less settled and is decided case by case.
Not sure whether this applies to you?
Ask an oncologistFrom diagnosis to a gene answer
Who gets tested, and how it happens
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Deciding who should be tested
International guidelines advise offering an inherited test to men whose prostate cancer has spread or is high-risk, and to men with a strong family history of prostate, breast, ovarian, pancreatic or bowel cancer.
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Counselling before the test
A genetic counsellor draws the family tree and explains what the test can find and what a result would mean for sons, daughters and siblings.
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One blood sample, many genes
A single sample is tested for a panel of genes at once. You do not need to fast, and the sample can be taken at any stage of treatment.
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The result
It will say a fault was found, no fault was found, or a change of uncertain meaning was found. Only the first changes care or family testing.
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What follows a positive result
Your oncologist looks at whether treatment should change, and your counsellor helps you tell relatives so they can be tested for the exact fault.
On your report
The words you will meet, in plain language
- Gene panel
- One test that reads many genes at once, instead of testing them one by one.
- DNA repair genes
- Genes, including BRCA2, ATM and PALB2, that fix damaged DNA. Faults in them let damage build up.
- Mismatch repair genes
- The four Lynch genes, which fix copying errors when cells divide.
- Germline
- Present in every cell from birth, so it can be inherited. The opposite is somatic, found only in the tumour.
- PARP inhibitor
- A type of tablet that works best against cancers with faulty DNA repair, such as some BRCA2 cancers.
- Polygenic risk score
- A combined estimate from many small gene differences. It is still a research tool, not a routine test.
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Side by side
A blood gene test and a tumour gene test are not the same
Blood test (inherited)
Tumour test (not inherited)
Looks for faults present from birth
Looks for faults only in the cancer cells
Matters for relatives as well as you
Matters for your treatment only
Usually done once in a lifetime
May be repeated as the cancer changes
Covered in these genetics pages
Covered in our targeted therapy pages
Commonly believed
Four things men tell us, and what is actually true
"My father had prostate cancer, so I must carry a faulty gene."
A father with prostate cancer does raise a son's risk, but most such families carry no single faulty gene. Shared ageing, habits and many small gene differences explain most of it.
"BRCA genes only matter for women."
BRCA2 is the single most important inherited gene for prostate cancer. Men carry BRCA faults as often as women do and pass them to sons and daughters alike.
"If no gene is found, my sons have nothing to worry about."
A negative test rules out the genes tested, not all risk. Your sons still have the family history, which on its own can be a reason to start PSA checks earlier.
"The tumour test already checked my genes."
A tumour test can hint at an inherited fault but cannot confirm one. If it finds a fault in a gene like BRCA2, a blood test is usually advised to see whether it was inherited.
Being straight with you
What this page cannot tell you
It cannot give you a personal risk figure. Estimates for each gene vary between studies, depend on the exact variant, and have mostly been measured outside India. A counsellor will explain the range that applies to your family, and how uncertain it is.
It cannot interpret your result
Two faults in the same gene can mean quite different things. What your specific variant means is a question for the counsellor who ordered the test. Testing a tumour to choose treatment is a separate subject, covered on our targeted therapy pages.
Who this does not apply to
Most men with prostate cancer do not need an inherited gene test. If you were diagnosed at an older age, your cancer is low-risk and confined to the prostate, and your family has no pattern of related cancers, testing is unlikely to change anything. Your oncologist will tell you honestly whether it is worth doing.
Not sure whether your family history counts? Write down who was diagnosed, with what and at roughly what age, on both sides.Questions we are asked
Common questions about prostate cancer genes
Which gene matters most for prostate cancer?
BRCA2. It has the strongest evidence, is linked to prostate cancer that comes younger and grows faster, and is the gene most likely to change treatment if the cancer spreads. It also matters for the breast and ovarian risk of women in the family.
Should every man with prostate cancer be tested?
No. Guidelines advise testing when the cancer has spread or is high-risk, or when the family history points to an inherited pattern. Most men with early, low-risk cancer and no such family history do not need it.
Does a gene fault change prostate cancer treatment?
It can, mainly when the cancer has spread. BRCA2 and some other DNA repair faults can make a group of tablets called PARP inhibitors an option. A Lynch fault can make immunotherapy worth considering. Your oncologist will say whether either applies.
Is HOXB13 common in Indian men?
This is not well known. The best-studied HOXB13 fault is found mainly in families of European ancestry, and research in Indian men is limited. If a panel finds a HOXB13 fault, a counsellor will explain what it means for you.
If I carry BRCA1, do I need prostate checks?
The link with prostate cancer is weaker than for BRCA2, so advice is less firm. Many teams still discuss PSA checks with male BRCA1 carriers. Your team will weigh your family history before recommending a schedule.
What is a variant of uncertain significance?
A change the laboratory cannot yet call harmful or harmless. It should not change your treatment, and relatives are usually not tested for it. Classifications are reviewed as evidence grows, so ask how you will be told if yours changes.
My test was negative. Does that help my brothers?
It helps. If the man who had cancer tests negative, there is usually no inherited fault for relatives to look for. Your brothers still share your family history, which can be a reason to start PSA checks earlier than usual.
How do I arrange a gene test in Hyderabad?
Ask your oncologist for a referral to genetic counselling, or call the CION helpline. Someone will explain which test suits your situation, what it is likely to cost and which reports to bring. Counselling in Telugu can be arranged.
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
- National Cancer Institute — Genetics of Prostate Cancer (PDQ) - Health Professional Version
- MedlinePlus Genetics — Prostate cancer
- National Cancer Institute — BRCA Gene Changes: Cancer Risk and Genetic Testing
- Cancer Research UK — Risks and causes of prostate cancer
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
Hereditary prostate cancer explainedThe bigger picture, before the gene detailsBRCA2 and prostate cancer risk in menThe gene with the strongest evidence, in depthHOXB13 mutation: which cancers and what riskIf your panel names HOXB13Prostate cancer and when genetic testing is advisedA plain check of whether you qualify
Talk to us
Should your prostate cancer be tested for an inherited gene?
Tell us about your diagnosis and your family history. We will tell you honestly whether a gene test is worth doing and arrange counselling if it is. One helpline serves every CION centre.