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Article|Articles in Press, 100898

Optimisation of polygenic risk scores in BRCA1/2 pathogenic variant heterozygotes in epithelial ovarian cancer

  • Nicola Flaum
    Correspondence
    Corresponding author: Dr Nicola Flaum, Manchester Centre for Genomic Medicine, St. Mary’s Hospital, Oxford Road, Manchester, M13 9WL, United Kingdom, Tel: 44 (0)7989 571285.
    Affiliations
    Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK

    North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
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  • John Bowes
    Affiliations
    Division of Musculoskeletal and Dermatological Sciences, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
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  • Miriam J. Smith
    Affiliations
    Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK

    North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK
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  • Emma J. Crosbie
    Affiliations
    Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK

    Division of Gynaecology, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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  • Richard Edmondson
    Affiliations
    Division of Cancer Sciences, School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK

    Division of Gynaecology, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester, UK
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  • Artitaya Lophatananon
    Affiliations
    Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
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  • D. Gareth Evans
    Affiliations
    Division of Evolution, Infection and Genomics, School of Biological Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester Academic Health Science Centre, UK

    North West Genomics Laboratory Hub, Manchester Centre for Genomic Medicine, St Mary’s Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, UK

    Prevention Breast Cancer Centre and Nightingale Breast Screening Centre, University Hospital of South Manchester, Manchester, UK

    The Christie NHS Foundation Trust, Manchester, UK

    Manchester Breast Centre, Manchester Cancer Research Centre, University of Manchester, UK
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Open AccessPublished:May 18, 2023DOI:https://doi.org/10.1016/j.gim.2023.100898
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      Abstract

      Purpose

      A third of familial epithelial ovarian cancer (EOC) is explained by BRCA1/2 pathogenic variants (PVs). Polygenic risk scores (PRSs) for BRCA1/2-heterozygotes associated with EOC have been created but impact of combination with clinical and hormonal risk factors is unclear.

      Methods

      We genotyped 300 cases and 355 controls and constructed modified PRSs based on those validated by Barnes et al. Model discrimination and EOC risk was assessed by area under the curve (AUC) values and difference between lowest and highest quintile odds ratios (ORs). We investigated model optimisation using logistic regression to combine models with clinical and hormonal data.

      Results

      Unadjusted AUC values were 0.526-0.551 with 2.2-2.3-fold increase in OR between lowest and highest quintiles (BRCA1-heterozygotes) and 0.574-0.585 AUC values with a 6.3-7.7-fold increase (BRCA2-heterozygotes). The optimised model (parity, age at menarche, menopause and first full-term pregnancy) estimated AUC values 0.872-0.876 and 21-23-fold increase in OR (BRCA1-heterozygotes) and AUC values of 0.857-0.867 and 40-41-fold increase (BRCA2-heterozygotes).

      Conclusions

      The combination of PRS with age, family history, and hormonal factors significantly improved the EOC risk discrimination ability. However, the contribution of the PRS was small. Larger prospective studies are needed to assess if combined-PRS models could provide information to inform risk-reducing decisions.