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. 2021 Jun;24(2):532-541.
doi: 10.1038/s41391-020-00311-2. Epub 2021 Jan 8.

Additional SNPs improve risk stratification of a polygenic hazard score for prostate cancer

Roshan A Karunamuni  1 Minh-Phuong Huynh-Le  2 Chun C Fan  3 Wesley Thompson  4 Rosalind A Eeles  5   6 Zsofia Kote-Jarai  5 Kenneth Muir  7   8 Artitaya Lophatananon  7 UKGPCS collaboratorsJohanna Schleutker  9   10 Nora Pashayan  11   12 Jyotsna Batra  13   14 APCB BioResource (Australian Prostate Cancer BioResource)Henrik Grönberg  15 Eleanor I Walsh  16 Emma L Turner  16 Athene Lane  16   17 Richard M Martin  16   17   18 David E Neal  19   20   21 Jenny L Donovan  22 Freddie C Hamdy  19   23 Børge G Nordestgaard  24   25 Catherine M Tangen  26 Robert J MacInnis  27   28 Alicja Wolk  29   30 Demetrius Albanes  31 Christopher A Haiman  32 Ruth C Travis  33 Janet L Stanford  34   35 Lorelei A Mucci  36 Catharine M L West  37 Sune F Nielsen  24   25 Adam S Kibel  38 Fredrik Wiklund  15 Olivier Cussenot  39   40 Sonja I Berndt  31 Stella Koutros  31 Karina Dalsgaard Sørensen  41   42 Cezary Cybulski  43 Eli Marie Grindedal  44 Jong Y Park  45 Sue A Ingles  46 Christiane Maier  47 Robert J Hamilton  48   49 Barry S Rosenstein  50   51 Ana Vega  52   53   54 IMPACT Study Steering Committee and CollaboratorsManolis Kogevinas  55   56   57   58 Kathryn L Penney  59 Manuel R Teixeira  60   61   62 Hermann Brenner  63   64   65 Esther M John  66 Radka Kaneva  67 Christopher J Logothetis  68 Susan L Neuhausen  69 Azad Razack  70 Lisa F Newcomb  34   71 Canary PASS InvestigatorsMarija Gamulin  72 Nawaid Usmani  73   74 Frank Claessens  75 Manuela Gago-Dominguez  76   77 Paul A Townsend  78 Monique J Roobol  79 Wei Zheng  80 Profile Study Steering CommitteeIan G Mills  81 Ole A Andreassen  82 Anders M Dale  83 Tyler M Seibert  84   85   86 PRACTICAL Consortium
Affiliations

Additional SNPs improve risk stratification of a polygenic hazard score for prostate cancer

Roshan A Karunamuni et al. Prostate Cancer Prostatic Dis. 2021 Jun.

Abstract

Background: Polygenic hazard scores (PHS) can identify individuals with increased risk of prostate cancer. We estimated the benefit of additional SNPs on performance of a previously validated PHS (PHS46).

Materials and method: 180 SNPs, shown to be previously associated with prostate cancer, were used to develop a PHS model in men with European ancestry. A machine-learning approach, LASSO-regularized Cox regression, was used to select SNPs and to estimate their coefficients in the training set (75,596 men). Performance of the resulting model was evaluated in the testing/validation set (6,411 men) with two metrics: (1) hazard ratios (HRs) and (2) positive predictive value (PPV) of prostate-specific antigen (PSA) testing. HRs were estimated between individuals with PHS in the top 5% to those in the middle 40% (HR95/50), top 20% to bottom 20% (HR80/20), and bottom 20% to middle 40% (HR20/50). PPV was calculated for the top 20% (PPV80) and top 5% (PPV95) of PHS as the fraction of individuals with elevated PSA that were diagnosed with clinically significant prostate cancer on biopsy.

Results: 166 SNPs had non-zero coefficients in the Cox model (PHS166). All HR metrics showed significant improvements for PHS166 compared to PHS46: HR95/50 increased from 3.72 to 5.09, HR80/20 increased from 6.12 to 9.45, and HR20/50 decreased from 0.41 to 0.34. By contrast, no significant differences were observed in PPV of PSA testing for clinically significant prostate cancer.

Conclusions: Incorporating 120 additional SNPs (PHS166 vs PHS46) significantly improved HRs for prostate cancer, while PPV of PSA testing remained the same.

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Figures

Figure 1.
Figure 1.. Cumulative incidence curves for PHS166.
Risk-adjusted cumulative incidence curves for the upper 5th percentile (>95th percentile) and upper 20th percentile (>80th percentile) of PHS166 scores for clinically significant and non-clinically-significant prostate cancer. Reference curves representing the population average cumulative incidence (i.e., unadjusted for genetic risk).

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