Predicting Metastatic Prostate Cancer Risk in a Diverse Population: Research from the 2022 Genitourinary Cancers Symposium

February 14, 2022
Brielle Gregory Collins, ASCO staff

The 2022 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium will be held in person and online February 17 to 19 in San Francisco, California. This meeting features research in the treatment and care of people with genitourinary (GU) cancers, which is a group of cancers that occur in the urinary tract or the male reproductive tract, including bladder cancerkidney cancer, and testicular cancer.

You can learn more about research from this symposium by following the #GU22 hashtag on Twitter.

Below is a summary of a study that will be presented at the symposium:

  • People with African ancestry have a higher risk of developing metastatic prostate cancer based on genetic risk scores

People with African ancestry have a higher risk of developing metastatic prostate cancer based on genetic risk scores

Who does this study affect: People in the general population at risk for developing prostate cancer.

What did this study find: A large U.S. study that used genetic risk scores to predict lifetime risk of developing or dying from metastatic prostate cancer in a diverse population found a strong association between the scores and overall risk. Higher genetic risk scores were associated with a higher risk of developing metastatic disease. The risk scores were also effective at predicting risk of dying from prostate cancer based on racial and ethnic background and family history of prostate cancer. The study found that people with African ancestry had the highest risk of developing or dying from metastatic prostate cancer.

Prostate cancer can run in families and is also more common in people with African ancestry. In the United States, Black men are more likely to die from prostate cancer than White men. There are recommendations to screen for prostate cancer so it may be found earlier, when the chances of curing the disease are higher. Currently, family history and race or ethnicity are major factors used to decide who should receive screening for prostate cancer and at what age.

Genetic risk scores can help in assessing an individual’s risk of developing a certain disease based on the specific genes they have inherited. In this study, researchers used a genetic risk scoring tool called PHS290, which is based on 290 genetic variants. A genetic variant is a change in the DNA sequence that makes up a particular gene, and certain genetic variants can increase a person’s cancer risk. The researchers in this study wanted to see if using a tool to analyze a person’s genetics, like PHS290, would be effective at predicting someone’s chances of developing advanced prostate cancer and possibly dying of the disease.

In the study, data were analyzed from 582,515 U.S. veterans enrolled in the Million Veteran Program. The goal of this national research program is “to learn how genes, lifestyle, and military exposure affect health and illness.” Across this diverse population, 425,251 (73%) had European ancestry, 104,582 (18%) had African ancestry, 45,668 (7.8%) had Hispanic ancestry, and 7,014 (1.2%) had Asian ancestry. The median age of the participants at their last follow-up was 69. The median is the midpoint, meaning half of the participants were younger than 69 and half were older than 69.

The researchers found that PHS290 scores were strongly associated with whether participants had a high or low risk of developing and dying from metastatic prostate cancer. Among the participants in the study population with the 20% highest PHS290 scores, the risk of developing prostate cancer was more than 5 times higher than the risk among the participants with the 20% lowest PHS290 scores. The risk of having metastatic prostate cancer and dying from prostate cancer was 4 times higher among these same people with the 20% highest PHS290 scores when compared with the people with the 20% lowest scores.

In particular, PHS290 scores were found to be higher on average in people with African ancestry. When compared to people with European ancestry, people with African ancestry had a 2.27 times higher risk of developing metastatic prostate cancer and a 1.97 times higher risk of dying from the disease. For people of Hispanic ancestry, the risk of developing and dying from prostate cancer was similar to that of European people. For Asian people, there were not enough people in the study to reliably calculate their risk. PHS290 scores also found higher risks of developing and dying from prostate cancer among those with a family history of prostate cancer.

What does this mean for patients: PHS290 found a higher risk of developing prostate cancer, developing metastatic prostate cancer, and dying from prostate cancer among people of African ancestry and those with a family history of prostate cancer. Genetic tools like PHS290 could provide additional information to help guide doctors when talking with their patients about prostate cancer screening with the goal of finding prostate cancer when it is still early.

Read the scientific abstract (#357030) and the authors’ disclosures on ASCO.org.

Read a press release about this abstract on ASCO.org.

“While most prior genetic studies have focused on men of European ancestry, our scoring algorithm is a measure of risk of dying of prostate cancer in a diverse population of military veterans. Even accounting for family history and ancestry, the scoring algorithm provided powerful additional information about a man’s risk of death due to prostate cancer.”

—   Meghana Pagadala, MD/PhD candidate
VA Health Care System
La Jolla, California

Like what you’ve read here at Cancer.Net? Sign up for our monthly Inside Cancer.Net e-newsletter and follow Cancer.Net on Facebook and Twitter for news about the latest in cancer care and treatment.

Share your thoughts on this blog post on Cancer.Net's Facebook and Twitter.