The Danger of Genetic Risk Scores for Worsening Race-Based Disparities in Healthcare
DOI:
https://doi.org/10.65539/87xk2m02Keywords:
polygenic risk scores, precision medicine, health disparities, genetic diversity, health equity, genomicsAbstract
This review examines how polygenic risk scores, developed primarily using data from white European populations, may worsen existing healthcare disparities. The author explains why these scores perform poorly in non-white populations, discusses the danger of clinical deployment without diverse representation in genetic databases, and proposes solutions including increasing diversity in genetic research and developing new analytical tools to improve prediction accuracy across different ancestry groups.
Downloads
References
Dewey FE, Grove ME, Pan C, et al. Clinical interpretation and implications of whole-genome sequencing. JAMA. 2014;311(10):1035-1045. DOI: https://doi.org/10.1001/jama.2014.1717
MacArthur J, Bowler E, Cerezo M, et al. The new NHGRI-EBI Catalog of published genome-wide association studies (GWAS Catalog). Nucleic Acids Res. 2017;45(D1):D896-D901. DOI: https://doi.org/10.1093/nar/gkw1133
Khera AV, Chaffin M, Aragam KG, et al. Genome-wide polygenic scores for common diseases identify individuals with risk equivalent to monogenic mutations. Nat Genet. 2018;50(9):1219-1224. DOI: https://doi.org/10.1038/s41588-018-0183-z
Torkamani A, Wineinger NE, Topol EJ. The personal and clinical utility of polygenic risk scores. Nat Rev Genet. 2018;19(9):581-590. DOI: https://doi.org/10.1038/s41576-018-0018-x
Natarajan P, Young R, Stitziel NO, et al. Polygenic Risk Score Identifies Subgroup With Higher Burden of Atherosclerosis and Greater Relative Benefit From Statin Therapy in the Primary Prevention Setting. Circulation. 2017;135(22):2091-2101. DOI: https://doi.org/10.1161/CIRCULATIONAHA.116.024436
Mavaddat N, Pharoah PD, Michailidou K, et al. Prediction of breast cancer risk based on profiling with common genetic variants. J Natl Cancer Inst. 2015;107(5).
Martin AR, Kanai M, Kamatani Y, Okada Y, Neale BM, Daly MJ. Clinical use of current polygenic risk scores may exacerbate health disparities. Nat Genet. 2019;51(4):584-591. DOI: https://doi.org/10.1038/s41588-019-0379-x
Choi SW, Mak TS, O'Reilly PF. Tutorial: a guide to performing polygenic risk score analyses. Nat Protoc. 2020;15(9):2759-2772. DOI: https://doi.org/10.1038/s41596-020-0353-1
Mills MC, Rahal C. A scientometric review of genome-wide association studies. Commun Biol. 2019;2:9. DOI: https://doi.org/10.1038/s42003-018-0261-x
Peterson RE, Kuchenbaecker K, Walters RK, et al. Genome-wide Association Studies in Ancestrally Diverse Populations: Opportunities, Methods, Pitfalls, and Recommendations. Cell. 2019;179(3):589-603. DOI: https://doi.org/10.1016/j.cell.2019.08.051
Duncan L, Shen H, Gelaye B, et al. Analysis of polygenic risk score usage and performance in diverse human populations. Nat Commun. 2019;10(1):3328. DOI: https://doi.org/10.1038/s41467-019-11112-0
Sohail M, Maier RM, Ganna A, et al. Polygenic adaptation on height is overestimated due to uncorrected stratification in genome-wide association studies. Elife. 2019;8. DOI: https://doi.org/10.7554/eLife.39702
Li D, Zhao H, Gelernter J. Strong protective effect of the aldehyde dehydrogenase gene (ALDH2) 504lys (*2) allele against alcoholism and alcohol-induced medical diseases in Asians. Hum Genet. 2012;131(5):725-737. DOI: https://doi.org/10.1007/s00439-011-1116-4
Sudlow C, Gallacher J, Allen N, et al. UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age. PLoS Med. 2015;12(3):e1001779. DOI: https://doi.org/10.1371/journal.pmed.1001779
Carroll NM, Blum-Barnett E, Madrid SD, et al. Demographic differences in the utilization of clinical and direct-to-consumer genetic testing. J Genet Couns. 2020;29(4):634-643. DOI: https://doi.org/10.1002/jgc4.1193
The "All of Us" Research Program. New England Journal of Medicine. 2019;381(7):668-676. DOI: https://doi.org/10.1056/NEJMsr1809937
Martin AR, Teferra S, Moller M, Hoal EG, Daly MJ. The critical needs and challenges for genetic architecture studies in Africa. Curr Opin Genet Dev. 2018;53:113-120. DOI: https://doi.org/10.1016/j.gde.2018.08.005
Grinde KE, Qi Q, Thornton TA, et al. Generalizing polygenic risk scores from Europeans to Hispanics/Latinos. Genet Epidemiol. 2019;43(1):50-62. DOI: https://doi.org/10.1002/gepi.22166
Marquez-Luna C, Loh PR, South Asian Type 2 Diabetes C, Consortium STD, Price AL. Multiethnic polygenic risk scores improve risk prediction in diverse populations. Genet Epidemiol. 2017;41(8):811-823. DOI: https://doi.org/10.1002/gepi.22083
Published
Issue
Section
License
Copyright (c) 2022 Sohail Zahid (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.