Ability of a polygenic risk score to refine colorectal cancer risk in Lynch syndrome

BackgroundPolygenic risk scores (PRSs) have been used to stratify colorectal cancer (CRC) risk in the general population, whereas its role in Lynch syndrome (LS), the most common type of hereditary CRC, is still conflicting. We aimed to assess the ability of PRS to refine CRC risk prediction in European-descendant individuals with LS. Methods1465 individuals with LS (557 MLH1, 517 MSH2/EPCAM, 299 MSH6 and 92 PMS2) and 5656 CRC-free population-based controls from two independent cohorts were included. A 91-SNP PRS was applied. A Cox proportional hazard regression model with 'family' as a random effect and a logistic regression analysis, followed by a meta-analysis combining both cohorts were conducted. ResultsOverall, we did not observe a statistically significant association between PRS and CRC risk in the entire cohort. Nevertheless, PRS was significantly associated with a slightly increased risk of CRC or advanced adenoma (AA), in those with CRC diagnosed ConclusionThe PRS may slightly influence CRC risk in individuals with LS in particular in more extreme phenotypes such as early-onset disease. However, the study design and recruitment strategy strongly influence the results of PRS studies. A separate analysis by genes and its combination with other genetic and non-genetic risk factors will help refine its role as a risk modifier in LS.

Automated summary

Polygenic risk scores (PRSs) have been used to stratify colorectal cancer (CRC) risk in the general population, but its role in Lynch syndrome (LS) is still conflicting. This study aimed to assess the ability of PRS to refine CRC risk prediction in European-descendant individuals with LS. The results showed that PRS was not significantly associated with CRC risk in the entire cohort, but it was slightly associated with an increased risk of CRC or advanced adenoma (AA) in individuals with early-onset disease.