title: Polygenic susceptibility to prostate and breast cancer: implications for personalised screening.
abstract: BACKGROUND
  We modelled the efficiency of a personalised approach to screening for prostate and breast cancer based on age and polygenic risk-profile compared with the standard approach based on age alone.
  
  
  METHODS
  We compared the number of cases potentially detectable by screening in a population undergoing personalised screening with a population undergoing screening based on age alone. Polygenic disease risk was assumed to have a log-normal relative risk distribution predicted for the currently known prostate or breast cancer susceptibility variants (N=31 and N=18, respectively).
  
  
  RESULTS
  Compared with screening men based on age alone (aged 55-79: 10-year absolute risk ≥2%), personalised screening of men age 45-79 at the same risk threshold would result in 16% fewer men being eligible for screening at a cost of 3% fewer screen-detectable cases, but with added benefit of detecting additional cases in younger men at high risk. Similarly, compared with screening women based on age alone (aged 47-79: 10-year absolute risk ≥2.5%), personalised screening of women age 35-79 at the same risk threshold would result in 24% fewer women being eligible for screening at a cost of 14% fewer screen-detectable cases.
  
  
  CONCLUSIONS
  Personalised screening approach could improve the efficiency of screening programmes. This has potential implications on informing public health policy on cancer screening.
authors.affiliation: Department of Public Health and Primary Care, Institute of Public Health, University of Cambridge, University Forvie Site, Robinson way, Cambridge CB2 0SR, UK. np275@medschl.cam.ac.uk
authors.forename: N
authors.initials: N
authors.lastname: Pashayan
authors.forename: S W
authors.initials: SW
authors.lastname: Duffy
authors.forename: S
authors.initials: S
authors.lastname: Chowdhury
authors.forename: T
authors.initials: T
authors.lastname: Dent
authors.forename: H
authors.initials: H
authors.lastname: Burton
authors.forename: D E
authors.initials: DE
authors.lastname: Neal
authors.forename: D F
authors.initials: DF
authors.lastname: Easton
authors.forename: R
authors.initials: R
authors.lastname: Eeles
authors.forename: P
authors.initials: P
authors.lastname: Pharoah
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000235:genetics*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D057285:Precision Medicine / Q000379:methods; D011471:Prostatic Neoplasms / Q000235:genetics*