Abstract

Genetic factors that influence etiologic mechanisms shared across cancers could affect the risk of multiple cancer types. We investigated polygenic risk score (PRS)-specific pleiotropy across 17 cancers in two large population-based cohorts. The study population included European ancestry individuals from the Genetic Epidemiology Research on Adult Health and Aging cohort (16,012 cases, 50,552 controls) and the UK Biobank (48,969 cases, 359,802 controls). We selected known independent risk variants from published GWAS to construct a PRS for each cancer type. Within cohorts, each PRS was evaluated in multivariable logistic regression models with respect to the cancer for which it was developed and each other cancer type. Results were then meta-analyzed across cohorts. In the UK Biobank, each PRS was additionally evaluated relative to 20 cancer risk factors or biomarkers. All PRS replicated associations with their corresponding cancers (p<0.05). Eleven cross-cancer associations - ten positive and one inverse - were found after correction for multiple testing (p<0.05/17=0.0029). Two cancer pairs showed bidirectional associations; the melanoma PRS was positively associated with oral cavity/pharyngeal cancer and vice versa, whereas the lung cancer PRS was positively associated with oral cavity/pharyngeal cancer, and the oral cavity/pharyngeal cancer PRS was inversely associated with lung cancer. We identified 65 associations between a cancer PRS and non-cancer phenotype. In this study examining cross-cancer PRS associations in two cohorts unselected for phenotype, we validated known and uncovered novel patterns of pleiotropy. Our results have the potential to inform investigations of risk prediction, shared etiology, and precision cancer prevention strategies. STATEMENT OF SIGNIFICANCEBy examining cross-cancer polygenic risk score associations, we validated known and uncovered novel patterns of pleiotropy. Our results may inform investigations of risk prediction, shared etiology, and precision prevention strategies.