Evaluation of polygenic risk scores for ovarian cancer risk prediction in a prospective cohort study.

BACKGROUND: Genome-wide association studies have identified >30 common SNPs associated with epithelial ovarian cancer (EOC). We evaluated the combined effects of EOC susceptibility SNPs on predicting EOC risk in an independent prospective cohort study. METHODS: We genotyped ovarian cancer susceptibility single nucleotide polymorphisms (SNPs) in a nested case-control study (750 cases and 1428 controls) from the UK Collaborative Trial of Ovarian Cancer Screening trial. Polygenic risk scores (PRSs) were constructed and their associations with EOC risk were evaluated using logistic regression. The absolute risk of developing ovarian cancer by PRS percentiles was calculated. RESULTS: The association between serous PRS and serous EOC (OR 1.43, 95% CI 1.29 to 1.58, p=1.3×10-11) was stronger than the association between overall PRS and overall EOC risk (OR 1.32, 95% CI 1.21 to 1.45, p=5.4×10-10). Women in the top fifth percentile of the PRS had a 3.4-fold increased EOC risk compared with women in the bottom 5% of the PRS, with the absolute EOC risk by age 80 being 2.9% and 0.9%, respectively, for the two groups of women in the population. CONCLUSION: PRSs can be used to predict future risk of developing ovarian cancer for women in the general population. Incorporation of PRSs into risk prediction models for EOC could inform clinical decision-making and health management

Penalized regression approaches to testing for quantitative trait-rare variant association

In statistical data analysis, penalized regression is considered an attractive approachfor its ability of simultaneous variable selection and parameter estimation. Althoughpenalized regression methods have shown many advantages in variable selection andoutcome prediction over other approaches for high-dimensional data, there is a relativepaucity of the literature on their applications to hypothesis testing, e.g. in geneticassociation analysis. In this study, we apply several new penalized regression methodswith a novel penalty, called Truncated L1-penalty (TLP) (Shen et al. 2012), foreither variable selection, or both variable selection and parameter grouping, in a dataadaptiveway to test for association between a quantitative trait and a group of rarevariants. The performance of the new methods are compared with some existing tests,including some recently proposed global tests and penalized regression-based methods,via simulations and an application to the real sequence data of the Genetic AnalysisWorkshop 17 (GAW17). Although our proposed penalized methods can improve oversome existing penalized methods, often they do not outperform some existing globalassociation tests. Some possible problems with utilizing penalized regression methodsin genetic hypothesis testing are discussed. Given the capability of penalized regressionin selecting causal variants and its sometimes promising performance, further studiesare warranted

Genetic risk models: Influence of model size on risk estimates and precision

Disease risk estimation plays an important role in disease prevention. Many studies have found that the ability to predict risk improves as the number of risk single-nucleotide polymorphisms (SNPs) in the risk model increases. However, the width of the confidence interval of the risk estimate is often not considered in the evaluation of the risk model. Here, we explore how the risk and the confidence interval width change as more SNPs are added to the model in the order of decreasing effect size, using both simulated data and real data from studies of abdominal aortic aneurysms and age-related macular degeneration. Our results show that confidence interval width is positively correlated with model size and the majority of the bigger models have wider confidence interval widths than smaller models. Once the model size is bigger than a certain level, the risk does not shift markedly, as 100% of the risk estimates of the one-SNP-bigger models lie inside the confidence interval of the one-SNP-smaller models. We also created a confidence interval-augmented reclassification table. It shows that both more effective SNPs with larger odds ratios and less effective SNPs with smaller odds ratios contribute to the correct decision of whom to screen. The best screening strategy is selected and evaluated by the net benefit quantity and the reclassification rate. We suggest that individuals whose upper bound of their risk confidence interval is above the screening threshold, which corresponds to the population prevalence of the disease, should be screened

Statistical methods for genetic association studies: detecting gene x environment interaction in rare variant analysis

Investigators have discovered thousands of genetic variants associated with various traits using genome-wide association studies (GWAS). These discoveries have substantially improved our understanding of the genetic architecture of many complex traits. Despite the striking success, these trait-associated loci collectively explain relatively little of disease risk. Many reasons for this unexplained heritability have been suggested and two understudied components are hypothesized to have an impact in complex disease etiology: rare variants and gene-environment (GE) interactions. Advances in next generation sequencing have offered the opportunity to comprehensively investigate the genetic contribution of rare variants on complex traits. Such diseases are multifactorial, suggesting an interplay of both genetics and environmental factors, but most GWAS have focused on the main effects of genetic variants and disregarded GE interactions. In this dissertation, we develop statistical methods to detect GE interactions for rare variant analysis for various types of outcomes in both independent and related samples. We leverage the joint information across a set of rare variants and implement variance component score tests to reduce the computational burden. First, we develop a GE interaction test for rare variants for binary and continuous traits in related individuals, which avoids having to restrict to unrelated individuals and thereby retaining more samples. Next, we propose a method to test GE interactions in rare variants for time-to-event outcomes. Rare variant tests for survival outcomes have been underdeveloped, despite their importance in medical studies. We use a shrinkage method to impose a ridge penalty on the genetic main effects to deal with potential multicollinearity. Finally, we compare different types of penalties, such as least absolute shrinkage selection operator and elastic net regularization, to examine the performance of our second method under various simulation scenarios. We illustrate applications of the proposed methods to detect gene x smoking interaction influencing body mass index and time-to-fracture in the Framingham Heart Study. Our proposed methods can be readily applied to a wide range of phenotypes and various genetic epidemiologic studies, thereby providing insight into biological mechanisms of complex diseases, identifying high-penetrance subgroups, and eventually leading to the development of better diagnostics and therapeutic interventions