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Arnau-Collell C, Díez-Villanueva A, Bellosillo B, Augé JM, Muñoz J, Guinó E, Moreira L, Serradesanferm A, Pozo À, Torà-Rocamora I, Bonjoch L, Ibañez-Sanz G, Obon-Santacana M, Moratalla-Navarro F, Sanz-Pamplona R, Márquez Márquez C, Rueda Miret R, Pérez Berbegal R, Piquer Velasco G, Hernández Rodríguez C, Grau J, Castells A, Borràs JM, Bessa X, Moreno V, Castellví-Bel S. Evaluating the Potential of Polygenic Risk Score to Improve Colorectal Cancer Screening. Cancer Epidemiol Biomarkers Prev 2022; 31:1305-1312. [PMID: 35511747 PMCID: PMC9355543 DOI: 10.1158/1055-9965.epi-22-0042] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 03/14/2022] [Accepted: 04/26/2022] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Colorectal cancer has high incidence and associated mortality worldwide. Screening programs are recommended for men and women over 50. Intermediate screens such as fecal immunochemical testing (FIT) select patients for colonoscopy with suboptimal sensitivity. Additional biomarkers could improve the current scenario. METHODS We included 2,893 individuals with a positive FIT test. They were classified as cases when a high-risk lesion for colorectal cancer was detected after colonoscopy, whereas the control group comprised individuals with low-risk or no lesions. 65 colorectal cancer risk genetic variants were genotyped. Polygenic risk score (PRS) and additive models for risk prediction incorporating sex, age, FIT value, and PRS were generated. RESULTS Risk score was higher in cases compared with controls [per allele OR = 1.04; 95% confidence interval (CI), 1.02-1.06; P < 0.0001]. A 2-fold increase in colorectal cancer risk was observed for subjects in the highest decile of risk alleles (≥65), compared with those in the first decile (≤54; OR = 2.22; 95% CI, 1.59-3.12; P < 0.0001). The model combining sex, age, FIT value, and PRS reached the highest accuracy for identifying patients with a high-risk lesion [cross-validated area under the ROC curve (AUROC): 0.64; 95% CI, 0.62-0.66]. CONCLUSIONS This is the first investigation analyzing PRS in a two-step colorectal cancer screening program. PRS could improve current colorectal cancer screening, most likely for higher at-risk subgroups. However, its capacity is limited to predict colorectal cancer risk status and should be complemented by additional biomarkers. IMPACT PRS has capacity for risk stratification of colorectal cancer suggesting its potential for optimizing screening strategies alongside with other biomarkers.
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Affiliation(s)
- Coral Arnau-Collell
- Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - Anna Díez-Villanueva
- Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Barcelona, Spain
| | - Beatriz Bellosillo
- Pathology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Josep M. Augé
- Biochemistry and Molecular Genetics Department, Hospital Clínic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Jenifer Muñoz
- Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - Elisabet Guinó
- Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Barcelona, Spain
| | - Leticia Moreira
- Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - Anna Serradesanferm
- Department of Preventive Medicine and Epidemiology, Clinical Institute of Internal Medicine and Dermatology, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona,Barcelona, Spain
| | - Àngels Pozo
- Department of Preventive Medicine and Epidemiology, Clinical Institute of Internal Medicine and Dermatology, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona,Barcelona, Spain
| | - Isabel Torà-Rocamora
- Department of Preventive Medicine and Epidemiology, Clinical Institute of Internal Medicine and Dermatology, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona,Barcelona, Spain
| | - Laia Bonjoch
- Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - Gemma Ibañez-Sanz
- Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Barcelona, Spain
| | - Mireia Obon-Santacana
- Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Barcelona, Spain
| | - Ferran Moratalla-Navarro
- Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Barcelona, Spain
| | - Rebeca Sanz-Pamplona
- Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Barcelona, Spain
| | - Carmen Márquez Márquez
- Gastroenterology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Rebeca Rueda Miret
- Pathology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Rocio Pérez Berbegal
- Gastroenterology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Gabriel Piquer Velasco
- Pathology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Cristina Hernández Rodríguez
- Unitat de Prevenció i Registre del Càncer, Servei d'Epidemiologia i Avaluació, Hospital del Mar, Barcelona, Spain
| | - Jaume Grau
- Department of Preventive Medicine and Epidemiology, Clinical Institute of Internal Medicine and Dermatology, Hospital Clinic of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona,Barcelona, Spain
| | - Antoni Castells
- Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Barcelona, Spain
| | - Josep M. Borràs
- Department of Clinical Sciences, University of Barcelona and Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Barcelona, Spain
| | - Xavier Bessa
- Gastroenterology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain
| | - Victor Moreno
- Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Barcelona, Spain.,Corresponding Authors: Victor Moreno, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Avinguda de la Granvia de l'Hospitalet, 199, L'Hospitalet de Llobregat 08908, Barcelona, Spain. Phone: 349-3260-7434; E-mail: ; and Sergi Castellví-Bel, Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Rosselló 149-153, Barcelona 08036, Spain. Phone: 349-3227-5707; E-mail:
| | - Sergi Castellví-Bel
- Gastroenterology Department, Hospital del Mar Medical Research Institute (IMIM), Barcelona, Spain.,Corresponding Authors: Victor Moreno, Bellvitge Biomedical Research Institute (IDIBELL), Catalan Institute of Oncology, Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP) and University of Barcelona, Avinguda de la Granvia de l'Hospitalet, 199, L'Hospitalet de Llobregat 08908, Barcelona, Spain. Phone: 349-3260-7434; E-mail: ; and Sergi Castellví-Bel, Gastroenterology Department, Hospital Clínic, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas (CIBEREHD), University of Barcelona, Rosselló 149-153, Barcelona 08036, Spain. Phone: 349-3227-5707; E-mail:
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