OBJECTIVES
Prostate cancer is the leading cancer among men in the Caribbean, yet early detection is limited by underrepresentation in genomic research and the invasive nature of standard screening methods, which many men avoid. This study aimed to evaluate the clinical utility of a commercial polygenic risk score (PRS) for stratifying prostate cancer risk in a predominantly African ancestry population from Bermuda.
METHODS
We analyzed genomic and clinical data from 157 male participants: 48 prostate cancer cases, 48 with a first-degree relative affected by prostate cancer, and 61 population controls. Each participant was assigned a PRS percentile and categorized as either low or high genetic risk. Multivariable logistic regression was used to assess the contribution of PRS, age, and family history to disease risk.
RESULTS
Among the prostate cancer cases, 56% were classified as high polygenic risk, while only 2% carried a monogenic pathogenic variant, highlighting the added value of PRS in capturing genetic risk. Age, family history, and PRS were identified as independent contributors to disease status. Notably, of the ten men without cancer with an elevated PSA level detected during the study, seven had high PRS scores, with one subsequently diagnosed with prostate cancer. The age range of prostate cancer cases with high PRS spanned from 42 to 80 years, indicating PRS as an additional tool for clinicians to use for men of all ages.
CONCLUSION
These findings support the use of PRS as a meaningful, non-invasive tool for risk stratification in Caribbean populations, particularly those of African ancestry. The data suggest that prostate cancer risk in this cohort is largely polygenic, contrasting with monogenic screening approaches. Incorporating PRS into early detection frameworks could enhance screening strategies and reduce disparities in cancer outcomes.
