Prostate Cancer Screening Program Beneficial in Top Decile of Polygenic Risk Score
By Elana Gotkine HealthDay Reporter
MONDAY, April 14, 2025 -- A prostate cancer screening program involving participants in the top decile of risk according to a polygenic risk score identifies clinically significant disease, according to a study published in the April 10 issue of the New England Journal of Medicine.
Jana K. McHugh, M.B., B.Ch., from the Institute of Cancer Research in London, and colleagues recruited people aged 55 to 69 years from primary care centers in the United Kingdom. Irrespective of prostate-specific antigen (PSA) level, participants with a polygenic risk score in the 90th percentile or higher were invited to undergo prostate cancer screening with multiparametric magnetic resonance imaging (MRI) and transperineal biopsy.
Overall, 745 participants had a score in the 90th percentile or higher and were invited to undergo screening; 468 (62.8) percent underwent MRI and prostate biopsy and 187 (40.0 percent) had prostate cancer detected. The researchers found that 103 of the 187 participants with cancer (55.1 percent) had prostate cancer classified as intermediate or higher risk according to the 2024 National Comprehensive Cancer Network (NCCN) criteria, with treatment indicated. In 74 (71.8 percent) of these participants, cancer would not have been detected according to the diagnostic pathway currently used in the United Kingdom (high PSA level and positive MRI results). Forty participants with cancer (21.4 percent) had disease classified as unfavorable intermediate risk or as high or very high risk according to NCCN criteria.
"Our results show that offering targeted screening to participants in at least the 90th percentile of genetic risk distribution as determined by a polygenic risk score resulted in the detection of prostate cancer warranting clinical management in 55.1 percent of these participants," the authors write.
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Posted April 2025
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