SAN DIEGO — Can genetic scores provide an objective measure of prostate cancer risk and aid screening decisions?
That was the question a study led by the VA San Diego Healthcare System recently sought to answer.
The study team, including participation from VAMCs in Salt Lake City and Boston, evaluated whether a polygenic hazard score based on 290 genetic variants (PHS290) was linked to prostate cancer risk in a diverse population. A special focus was on Black men, who have a higher average risk of prostate cancer death but are often treated as a homogeneously high-risk group, according to study authors.
The retrospective analysis used data from the Million Veteran Program (MVP), a national, population-based cohort study of U.S. military veterans conducted from 2011-2021. Included were 590,750 male participants, with median age at last follow-up of 69.
Results reported in the Journal of the National Cancer Institute found that PHS290 was associated with fatal prostate cancer in the full cohort and for each racial and ethnic group (p<0.001). “Comparing men in the highest 20% of PHS290 to those in the lowest 20% (based on percentiles from an independent training cohort), the hazard ratio for fatal prostate cancer was 4.42 [95%CI: 3.91-5.02],” the researchers wrote. “When accounting for guideline-recommended risk factors (family history, race and ethnicity), PHS290 remained a strong independent predictor of any, metastatic, and fatal prostate cancer.”1
The study concluded that the presence of PHS290 stratified U.S. veterans of diverse ancestry for lifetime risk of prostate cancer, including metastatic and fatal cancer. “Predicting genetic risk of lethal prostate cancer with PHS290 might inform individualized decisions about prostate cancer screening,” they added.
- Pagadala MS, Lynch J, Karunamuni R, Alba PR, et. al. Polygenic risk of any, metastatic, and fatal prostate cancer in the Million Veteran Program. J Natl Cancer Inst. 2022 Oct 28:djac199. doi: 10.1093/jnci/djac199. Epub ahead of print. PMID: 36305680.