(UroToday.com) The American Urologic Association (AUA) annual meeting’s evolving landscape of advanced prostate cancer treatment session included a talk by Dr. Leonard Gomella discussing genetic testing in advanced prostate cancer. Dr. Gomella notes that there have been rapid advances in prostate cancer genetic testing, reflected in changes made to the NCCN guidelines from 2016-2020. Before 2016, prostate cancer and BRCA were only discussed in the Hereditary Breast and Ovarian Cancer (HBOC) Guidelines, followed by early 2016 guidelines noting the first mention of a family history of BRCA1/2 for screening patients. The 2017 prostate cancer guidelines noted the first familial/hereditary genetic considerations, emphasizing that the following should be considered “brother or father or multiple family members diagnosed with prostate cancer at less than 50 years of age, germline DNA repair gene abnormalities, especially BRCA2 mutation or Lynch Syndrome (germline mutations in MLH1, MSH2, MSH6, or PMS2) and/or strong family history for breast or ovarian cancer (suggests the possibility of BRCA2 mutation) or colorectal, endometrial, gastric, ovarian, pancreatic, small bowel, urothelial, kidney, or bile duct cancer (suggests the possibility of Lynch syndrome).” In the 2018 NCCN prostate cancer guideline, there was the first “consideration” for germline testing based on risk, and in 2020, there was a change in terminology to germline testing being “recommended” based on risk.