Polygenic Risk Score for Defining Personalized Surveillance Intervals After Adenoma Detection and Removal at Colonoscopy

Polygenic Risk Scores for Follow Up After Colonoscopy and Polypectomy: Another Tool for Risk Stratification and Planning Surveillance?

“…The findings of Guo et al 12 may be considered in the larger context of attempts to optimize risk stratification and surveillance of individuals after colonoscopy. Mechanisms driving CRC risk after polypectomy may be broadly categorized into biologic factors and colonoscopy quality factors (Figure 1).…”

“…In this issue of Clinical Gastroenterology and Hepatology, Guo et al 12 aimed to address this evidence gap by examining whether a PRS, along with adenoma characteristics, could improve risk stratification of individuals after polyp removal. They conducted a population-based case-control study in Germany among 4696 CRC cases, and 3709 CRC-free control subjects.…”

“…[19][20][21][22] Family history of CRC increases risk for metachronous advanced neoplasia after polypectomy. 23 Considered together with the finding of Guo et al 12 that CRC-associated SNPs, as summarized by a PRS, genetic predisposition can be postulated to be a useful tool for postpolypectomy CRC risk stratification, and the clinical utility for PRS in the setting of postpolypectomy patients may be further enhanced with the additional discovery and validation of additional CRC risk SNPs.…”

“…29 In summary, work to date on risk stratification suggests that multiple factors associated with metachronous CRC risk can be identified, and that models incorporating these factors can improve risk stratification. Work by Guo et al 12 and others also underscores that single factors, such as a PRS alone, are unlikely to be adequate to achieve optimal risk stratification. However, work by Guo et al 12 and others also suggests that there is an opportunity to leverage well-established biologic and quality factors, such as age, sex, and extent of examination, and emerging factors, such as information on genetic predisposition and colonoscopist ADR, to develop even better, more comprehensive models for risk stratification.…”

“…Work by Guo et al 12 and others also underscores that single factors, such as a PRS alone, are unlikely to be adequate to achieve optimal risk stratification. However, work by Guo et al 12 and others also suggests that there is an opportunity to leverage well-established biologic and quality factors, such as age, sex, and extent of examination, and emerging factors, such as information on genetic predisposition and colonoscopist ADR, to develop even better, more comprehensive models for risk stratification. Although questionnaire-based, clinical and PRSbased tools seem to be clinically useful, incorporating additional blood-based markers (eg, information from the blood epigenome) 32,33 may provide a novel path toward improving further CRC risk prediction.…”