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Meta-Analysis
. 2023 Apr;21(2):316.e1-316.e11.
doi: 10.1016/j.clgc.2022.09.006. Epub 2022 Sep 11.

How Well do Polygenic Risk Scores Identify Men at High Risk for Prostate Cancer? Systematic Review and Meta-Analysis

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Free article
Meta-Analysis

How Well do Polygenic Risk Scores Identify Men at High Risk for Prostate Cancer? Systematic Review and Meta-Analysis

Aino Siltari et al. Clin Genitourin Cancer. 2023 Apr.
Free article

Abstract

Objectives: Genome-wide association studies have revealed over 200 genetic susceptibility loci for prostate cancer (PCa). By combining them, polygenic risk scores (PRS) can be generated to predict risk of PCa. We summarize the published evidence and conduct meta-analyses of PRS as a predictor of PCa risk in Caucasian men.

Patients and methods: Data were extracted from 59 studies, with 16 studies including 17 separate analyses used in the main meta-analysis with a total of 20,786 cases and 69,106 controls identified through a systematic search of ten databases. Random effects meta-analysis was used to obtain pooled estimates of area under the receiver-operating characteristic curve (AUC). Meta-regression was used to assess the impact of number of single-nucleotide polymorphisms (SNPs) incorporated in PRS on AUC. Heterogeneity is expressed as I2 scores. Publication bias was evaluated using funnel plots and Egger tests.

Results: The ability of PRS to identify men with PCa was modest (pooled AUC 0.63, 95% CI 0.62-0.64) with moderate consistency (I2 64%). Combining PRS with clinical variables increased the pooled AUC to 0.74 (0.68-0.81). Meta-regression showed only negligible increase in AUC for adding incremental SNPs. Despite moderate heterogeneity, publication bias was not evident.

Conclusion: Typically, PRS accuracy is comparable to PSA or family history with a pooled AUC value 0.63 indicating mediocre performance for PRS alone.

Keywords: Genetic variance; Polygenic risk score; Prostate cancer risk; Single-nucleotide polymorphism.

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Conflict of interest statement

Declaration of interests The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Anssi Auvinen: Lecture fee (Amgen/Janssen), Amit Kiran is salaried by Astellas who have a product for prostate cancer, Teemu J Murtola: Consultant fees from Astellas, Janssen, speaker's honorarium from Astellas, Janssen and Sanofi, participation in scientific meetings at the expense of Ferring, Pfizer and Sanofi, stockholder for Arocell ab. All other authors declare no conflict of interest.

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