Polygenic Risk Scores for Pre-MRI Risk Stratification in Men with Suspected Prostate Cancer

This prospective study assessed whether adding polygenic risk scores (PRS) to standard clinical markers can more efficiently guide MRI usage in men with suspected prostate cancer.

The results showed that PRS was a strong, statistically significant predictor of MRI positivity , with higher scores associated with a greater likelihood of suspicious findings. In contrast, PSA alone did not significantly predict MRI outcomes in this cohort. When combined into multivariable models, age and PRS together outperformed PSA-based approaches. Decision curve analysis demonstrated that this combined model provided the highest clinical utility , increasing the proportion of MRI-positive cases by 14% compared to using PSA alone (60% vs. 46%).

In summary , adding genetic risk via PRS improves risk stratification for men evaluated for prostate cancer, helping prioritize MRI use, reduce unnecessary imaging in low-risk individuals, and improve efficiency in care.

J Natl Cancer Inst. 2026 Feb 2:djag 027.doi:10.1093/jnci/djag027. Online ahead of print.