Multi-parametric magnetic resonance imaging (mpMRI) has emerged as an important tool for identifying clinically-significant prostate cancer. We examined if the addition of a 400-variant multi-ancestry polygenic risk score (PRS) to mpMRI has the potential to improve identification. Based on data from 24,617 men from the Mass General Brigham Biobank, we identified 1,243 men who underwent mpMRI. Men in the top PRS quartile were more likely to have clinically-significant prostate cancer (47.1% vs 28.6% in the bottom PRS quartile, adjusted relative proportion 1.72 [95% CI 1.35-2.19]). Both among men with a positive and a negative mpMRI, men in the top PRS quartile had the highest frequency of clinically-significant cancer. In a constructed scenario for selecting men to undergo biopsy, use of the PRS lowered the frequency of missed clinically-significant cancers from 9.1% to 5.9%. Our study provides initial support for using the PRS to improve identification of potentially lethal prostate cancer.
JNCI cancer spectrum. 2024 Mar 01 [Epub ahead of print]
Anna Plym, Ikenna Madueke, Sachin Naik, Mark Isabelle, David V Conti, Christopher A Haiman, Kathryn L Penney, Lorelei A Mucci, Rhamin Khorasani, Adam S Kibel
Department of Urology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States., Center for Evidence-Based Imaging, Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, United States., Center for Genetic Epidemiology, Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, California, United States., Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, United States.