OBJECTIVE: To evaluate the role of targeted prostate cancer screening in men 
with BRCA1 or BRCA2 mutations, an international study, IMPACT (Identification of 
Men with a genetic predisposition to ProstAte Cancer: Targeted screening in 
BRCA1/2 mutation carriers and controls), was established. This is the first 
multicentre screening study targeted at men with a known genetic predisposition 
to prostate cancer. A preliminary analysis of the data is reported.
PATIENTS AND METHODS: Men aged 40-69 years from families with BRCA1 or BRCA2 
mutations were offered annual prostate specific antigen (PSA) testing, and those 
with PSA > 3 ng/mL, were offered a prostate biopsy. Controls were men 
age-matched (± 5 years) who were negative for the familial mutation.
RESULTS: In total, 300 men were recruited (205 mutation carriers; 89 BRCA1, 116 
BRCA2 and 95 controls) over 33 months. At the baseline screen (year 1), 7.0% 
(21/300) underwent a prostate biopsy. Prostate cancer was diagnosed in ten 
individuals, a prevalence of 3.3%. The positive predictive value of PSA 
screening in this cohort was 47·6% (10/21). One prostate cancer was diagnosed at 
year 2. Of the 11 prostate cancers diagnosed, nine were in mutation carriers, 
two in controls, and eight were clinically significant.
CONCLUSIONS: The present study shows that the positive predictive value of PSA 
screening in BRCA mutation carriers is high and that screening detects 
clinically significant prostate cancer. These results support the rationale for 
continued screening in such men.