Characterizing Genetic Risk at Known Prostate Cancer
Susceptibility Loci in African Americans
Christopher A. Haiman1*, Gary K. Chen1, William J. Blot2,3,4, Sara S. Strom5, Sonja I. Berndt6, Rick A.
Kittles7, Benjamin A. Rybicki8, William B. Isaacs9, Sue A. Ingles1, Janet L. Stanford10, W. Ryan Diver11,
John S. Witte12, Stephen J. Chanock6, Suzanne Kolb10, Lisa B. Signorello2,3,4, Yuko Yamamura5, Christine
Neslund-Dudas8, Michael J. Thun11, Adam Murphy13, Graham Casey1, Xin Sheng1, Peggy Wan1, Loreall C.
Pooler1, Kristine R. Monroe1, Kevin M. Waters1, Loic Le Marchand14, Laurence N. Kolonel14, Daniel O.
Stram1, Brian E. Henderson1
1Department of Preventive Medicine, Keck School of Medicine and Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, California, United
States of America, 2International Epidemiology Institute, Rockville, Maryland, United States of America, 3Division of Epidemiology, Department of Medicine, Vanderbilt
Epidemiology Center, Vanderbilt University, Nashville, Tennessee, United States of America, 4Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, United States of
America, 5Department of Epidemiology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas, United States of America, 6Division of Cancer
Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland, United States of America, 7Department of Medicine, University of
Illinois at Chicago, Chicago, Illinois, United States of America, 8Department of Biostatistics and Research Epidemiology, Henry Ford Hospital, Detroit, Michigan, United
States of America, 9James Buchanan Brady Urological Institute, Johns Hopkins Hospital and Medical Institutions, Baltimore, Maryland, United States of America,
10Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America, 11Epidemiology Research Program,
American Cancer Society, Atlanta, Georgia, United States of America, 12Institute for Human Genetics, Departments of Epidemiology and Biostatistics and Urology,
University of California San Francisco, San Francisco, California, United States of America, 13Department of Urology, Northwestern University, Chicago, Illinois, United
States of America, 14Epidemiology Program, Cancer Research Center, University of Hawaii, Honolulu, Hawaii, United States of America
GWAS of prostate cancer have been remarkably successful in revealing common genetic variants and novel biological
pathways that are linked with its etiology. A more complete understanding of inherited susceptibility to prostate cancer in
the general population will come from continuing such discovery efforts and from testing known risk alleles in diverse racial
and ethnic groups. In this large study of prostate cancer in African American men (3,425 prostate cancer cases and 3,290
controls), we tested 49 risk variants located in 28 genomic regions identified through GWAS in men of European and Asian
descent, and we replicated associations (at p#0.05) with roughly half of these markers. Through fine-mapping, we identified
nearby markers in many regions that better define associations in African Americans. At 8q24, we found 9 variants
(p#661024) that best capture risk of prostate cancer in African Americans, many of which are more common in men of
African than European descent. The markers found to be associated with risk at each locus improved risk modeling in
African Americans (per allele OR=1.17) over the alleles reported in the original GWAS (OR=1.08). In summary, in this
detailed analysis of the prostate cancer risk loci reported from GWAS, we have validated and improved upon markers of risk
in some regions that better define the association with prostate cancer in African Americans. Our findings with variants at
8q24 also reinforce the importance of this region as a major risk locus for prostate cancer in men of African ancestry.
Citation: Haiman CA, Chen GK, Blot WJ, Strom SS, Berndt SI, et al. (2011) Characterizing Genetic Risk at Known Prostate Cancer Susceptibility Loci in African
Americans. PLoS Genet 7(5): e1001387. doi:10.1371/journal.pgen.1001387
Editor: Emmanouil T. Dermitzakis, University of Geneva Medical School, Switzerland
Received September 29, 2010; Accepted April 21, 2011; Published May 26, 2011
This is an open-access article, free of all copyright, and may be freely reproduced, distributed, transmitted, modified, built upon, or otherwise used by anyone for
any lawful purpose. The work is made available under the Creative Commons CC0 public domain dedication.
Funding: The MEC and the genotyping in this study were supported by NIH grants CA63464, CA54281, CA1326792, CA148085, and HG004726. Genotyping of
the PLCO samples was funded by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics, NCI, NIH. LAAPC was funded by grant
99-00524V-10258 from the Cancer Research Fund, under Interagency Agreement #97-12013 (University of California contract #98-00924V) with the Department
of Health Services Cancer Research Program. Cancer incidence data for the MEC and LAAPC studies have been collected by the Los Angeles Cancer Surveillance
Program of the University of Southern California with federal funds from the NCI, NIH, Department of Health and Human Services, under Contract No. N01-PC-
35139, and the California Department of Health Services as part of the state-wide cancer reporting program mandated by California Health and Safety Code
Section 103885, and grant number 1U58DP000807-3 from the Centers for Disease Control and Prevention. KCPCS was supported by NIH grants R01 CA056678,
R01 CA082664, R01 CA092579, with additional support from the Fred Hutchinson Cancer Research Center. MDA was support by grants, R01CA68578, DAMD
W81XWH-07-1-0645, and P50-CA140388. GECAP was supported by NIH grant ES011126. CaP Genes was supported by CA88164. IPCG was support by DOD grant
W81XWH-07-1-0122. DCPC was supported by NIH grant S06GM08016 and DOD grants DAMD W81XWH-07-1-0203 and DAMD W81XWH-06-1-0066. SCCS is
funded by NIH grant CA092447, and SCCS sample preparation was conducted at the Epidemiology Biospecimen Core Lab that is supported in part by the
Vanderbilt-Ingram Cancer Center (P30 CA68485). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the
Competing Interests: The authors have declared that no competing interests exist.
* E-mail: firstname.lastname@example.org
PLoS Genetics | www.plosgenetics.org1 May 2011 | Volume 7 | Issue 5 | e1001387
Genome-wide association studies (GWAS) have revealed more
than 30 variants that contribute susceptibility to prostate cancer,
with most of the discoveries having been made in populations of
European ancestry [1–14]. However, as so far observed for most
common diseases, variants identified through GWAS are of low
risk both individually and in aggregate, and therefore provide only
limited information about disease prediction [15,16]. Most risk
variants for prostate cancer are located outside of annotated genes,
with some positioned in gene poor regions and some regions
harboring more than one independent signal [1,10,14,17,18].
Thus, for the vast majority of risk loci, the identity, frequency and
risk associated with the underlying biologically relevant allele(s) are
unknown. The risk variants revealed through GWAS have also
been found to vary in frequency across racial/ethnic populations
. Even in the absence of functional data, the associated risk
variants may highlight a genetic basis for differences in disease risk
between populations, such as at 8q24 where genetic variation is
suggested to contribute to population differences in risk of prostate
cancer . Testing of the risk variants and fine-mapping in
diverse populations will help to identify and localize the subset of
markers that best define risk of the functional allele(s) within
known risk loci, as well as to determine their contribution to racial
and ethnic differences in prostate cancer risk.
In the present study, we tested common genetic variation at the
prostate cancer risk loci identified in men of European and Asian
descent in a large sample comprised of 3,425 African American
prostate cancer cases and 3,290 controls, to identify markers of risk
that are relevant to this population. More specifically, we
conducted GWAS and imputation-based fine-mapping of each
risk locus to both improve the current set of risk markers in African
Americans as well as to identify new risk variants for prostate
cancer. We then applied this information to model the genetic risk
of prostate cancer in African American men.
The African American prostate cancer cases (n=3,621) and
controls (n=3,502) in this study are part of a collaborative
genome-wide scan of prostate cancer that includes 11 individual
studies (Table S1, Methods). Samples were genotyped using the
Illumina Infinium 1M-Duo bead array, and following quality
control exclusions (see Methods), the analysis of variants at the
known risk loci was performed on 3,425 cases and 3,290 controls.
The ages of cases and controls ranged from 23 to 95, with cases
and controls having similar ages (mean 65 and 64 years,
We tested 49 known prostate cancer risk variants located in 28
risk regions (Table S2, Table 1, and Table 2); 43 SNPs were
directly genotyped (with call rates .95%), while 6 were imputed
with high accuracy (see Methods) [1,3,4,6–14,17,18,20–23]. The
minor allele frequencies (MAF) of all 49 variants were common
($0.05) in African Americans, except for rs721048 at 2p15 (MAF,
0.04) and rs12621278 at 2q21 (MAF, 0.02; Table 1, Figure 1). On
average, across all variants tested, the risk allele frequencies (RAFs,
i.e. alleles associated with an increased risk of prostate cancer in
previous GWAS) were 0.05 greater in African Americans than in
Europeans. However, when removing the 12 risk variants at 8q24
(Table 2) the average difference in RAF over the remaining risk
loci was only 0.03.
We examined the association of local ancestry with prostate
cancer risk at each of the 28 risk regions (Table S3). In addition to
8q24, which we had previously found to be strongly associated
with African ancestry  (OR per European chromosome=0.81,
p=4.761025), we observed significant associations at 22q13
(OR=0.88, p=0.01), 7p15 (OR=1.16, p=1.661023) and 10q26
(OR=1.14, p=6.261023). To address the potential for con-
founding by genetic ancestry, we adjusted for both global and local
ancestry in all analyses (see Methods).
In previous GWAS, the index signals outside of 8q24 had very
modest odds ratios (1.05–1.30 per copy of the risk allele) and our
sample size provided $80% power to detect the reported effects
for 24 of the 37 variants (at p,0.05; Table S2). We observed
positive associations with 28 of the 37 variants (odds ratios (OR)
.1) in African Americans and 18 reached nominal statistical
significance (p#0.05; Table 1). Results were similar without
adjustment for local ancestry in each region (Table S4). Of the 19
variants that were not replicated at p,0.05, power was ,80% for
9 of the variants.
While power was limited to detect associations at some loci, the
lack of replication at loci where power was acceptable (.80%)
suggests that the particular risk variant revealed in GWAS in
European and Asian populations may not be adequately correlated
with the biologically relevant allele in African Americans. In an
attempt to identify a better genetic marker of the biologically
relevant allele in African Americans we conducted fine-mapping
across all risk regions using genotyped SNPs on the 1 M array and
imputed SNPs to Phase 2 HapMap (Table S5, see Methods). If a
marker associated with risk in African Americans represents the
same signal as that reported in the initial GWAS, then it should be
correlated to some degree with the index signal in the initial GWAS
population. Using HapMap data (CEU or JPT+CHB depending
upon the initial GWAS population) we catalogued and tested all
SNPs that were correlated (r2$0.2) with the index signal (within
250 kb), applying a significance criteria aa, of 0.004 given the large
number of correlated tests. This level of significance was based on
the number tag SNPs in the HapMap YRI population that capture
(r2$0.8) all SNPs that were correlated with the index signal in the
HapMap CEU (r2$0.2; see Methods). We also looked for novel
independent associations, focusing on the genotyped and imputed
SNPs that were uncorrelated with the index signal in the initial
GWAS populations. Here, we applied a Bonferroni correction for
defining novel associations as significant in each region, with ab
estimated as 0.05/the total number of tags needed to capture
(r2$0.8) all common risk alleles across all risk region in the YRI
population (ab=5.661026). This is similar to the genome-wide-
type correction of 561028, which accounts for the number of tags
Prostate cancer is one of the most common cancers in
men and is especially frequent in men of African origin, as
incidence rates in African Americans in the United States
are .1.5–fold greater than rates in European Americans. In
order to gain a more complete understanding of the
genetic basis of inherited susceptibility to prostate cancer
in men of African origin, we examined the associations at
risk loci identified in men of European and Asian descent in
a large African American sample of 3,425 cases of prostate
cancer and 3,290 male controls. In testing 49 known risk
variants, we were able to demonstrate that at least half of
these variants also contribute to risk in African American
men. We were able to find additional risk variants in many
of the previously reported regions that better captured the
pattern of risk in African American men. In addition, we
verified and improved upon the evidence we previously
reported that there are multiple risk variants in a region of
8q24 that are important in men of African origin.
Genetics of Prostate Cancer in African Americans
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Table 1. Associations with common variants at known prostate cancer risk regions in African Americans (3,425 cases, 3,290 controls).
Index SNP from GWAS Best Marker in African Americans
RAF (EA/AA)b, OR (95% CI)c
RAF (AA)b, OR (95% CI)c
r2with index in GWAS
2p24,rs13385191 20,751,746,G/A 0.61f/0.06, 0.99(0.84–1.16) 0.90rs340623g20,795,759,C/T 0.17, 1.15(1.05–1.27) 3.861023
2p21,rs1465618 43,407,453,T/C0.23/0.12, 1.07(0.96–1.20) 0.22 -----j
2p15, rs721048 62,985,235,A/G 0.19/0.04, 1.24(1.03–1.50) 0.025 -----
2p15,rs2710647 63,067,474,C/T0.55/0.46, 1.16(1.08–1.25) 2.861025
rs6545977 63,154,668,G/A0.48, 1.18(1.10–1.27) 2.361026
2q21,rs12621278 173,019,799,A/G0.94/0.98, 1.44(1.05–1.99) 0.026 rs12620581g173,037,960,A/G 0.75, 1.13(1.04–1.23) 3.861023
3p12,rs2660753 87,193,364,T/C 0.11/0.49, 0.97(0.90–1.05) 0.50-----
3q21,rs10934853 129,521,063,A/C 0.28/0.70, 1.03(0.95–1.13) 0.43rs7641133 129,319,009,T/C0.29, 1.16(1.08–1.25) 1.061024
4q22,rs12500426 95,733,632,A/C 0.46/0.40, 1.00(0.93–1.07) 0.99 -----
4q22,rs17021918 95,781,900,C/T 0.66/0.78, 1.08(0.99–1.18) 0.066-----
4q24,rs7679673g106,280,983,C/A0.55/0.39, 1.08(1.00–1.16) 0.050 -----
5p15,rs401681 1,375,087,C/T 0.55/0.41, 0.94(0.87–1.00) 0.068-----
5p15,rs12653946 1,948,829,T/C 0.43f/0.41, 1.05(0.98–1.13) 0.15-----
6p21,rs1983891 41,644,405,T/C 0.38f/0.48, 1.09(1.01–1.17) 0.024 -----
6q22,rs339331 117,316,745,T/C0.63f/0.75, 1.22(1.12–1.32) 3.161026
rs12202378g117,348,714,T/C 0.70, 1.25(1.15–1.35) 8.861028
6q25,rs9364554 160,753,654,T/C 0.29/0.06, 1.30(1.11–1.52) 8.261024
rs2076828 160,792,776,C/G0.56, 1.14(1.06–1.22) 3.561024
7p15,rs10486567 27,943,088,G/A 0.77/0.71, 1.15(1.07–1.25) 2.961024
rs7808935g27,943,888,T/C 0.70, 1.16(1.07–1.25) 2.661024
7q21,rs6465657 97,654,263,C/T0.46/0.87, 1.00(0.87–1.14) 0.95-----
8p21,rs2928679 23,494,920,A/G0.42/0.27, 1.02(0.94–1.10) 0.60 -----
8p21,rs1512268 23,582,408,T/C 0.45/0.63, 1.12(1.04–1.20) 3.261023
rs11782388g23,581,303,C/T 0.70, 1.18(1.09–1.28) 9.861025
10q11,rs10993994 51,219,502,T/C0.40/0.60, 1.09(1.02–1.17) 0.017rs4630243g51,210,873,T/C 0.76, 1.14(1.05–1.25) 2.361023
10q26, rs4962416 126,686,862,C/T 0.27/0.16, 1.05(0.96–1.16) 0.28-----
11p15, rs7127900 2,190,150,A/G 0.20/0.36, 1.09(1.01–1.17) 0.027-----
11q13,rs12418451g68,691,995,A/G0.28/0.13, 1.13(1.01–1.27) 0.030 -----
11q13,rs11228565 68,735,156,A/G0.20/0.10, 1.08(0.96–1.21) 0.18rs11228580g68,758,918,C/T 0.16, 1.31(1.20–1.44) 9.761029
11q13, rs7931342 68,751,073,G/T0.51/0.78, 1.13(1.03–1.24) 8.961023
11q13,rs10896449 68,751,243,G/A 0.52/0.67, 1.15(1.06–1.24) 3.761024
13q22,rs9600079 72,626,140,T/G0.35f/0.52, 0.98(0.91–1.05) 0.53-----
17p12, rs4054823 13,565,749,T/C0.56/0.68, 0.99(0.92–1.06) 0.74-----
17q12,rs11649743 33,149,092,G/A 0.80/0.91, 1.15(1.01–1.31) 0.041 -----
17q12, rs4430796 33,172,153,A/G0.53/0.35, 1.02(0.95–1.10) 0.52-----
17q12,rs7501939 33,175,269,C/T0.58/0.49, 1.03(0.96–1.10) 0.44 -----
17q24, rs1859962 66,620,348,G/T0.46/0.30, 0.99(0.92–1.07) 0.84 -----
19q13, rs8102476 43,427,453,C/T0.54/0.74, 1.12(1.03–1.21) 8.561023
19q13, rs266849 56,040,902,A/G0.80/0.88, 1.01(0.91–1.13) 0.85rs3760722i56,049,628,C/T0.72, 1.14(1.05–1.24) 1.561023
19q13, rs2735839 56,056,435,G/A0.85/0.69, 0.94(0.87–1.02) 0.12 -----
22q13, rs5759167 41,830,156,G/T0.53/0.75, 1.10(1.01–1.20) 0.024 -----
Xp11, rs5945572 51,246,423,A/G0.35/0.14, 1.21(1.09–1.35) 5.261024
rs4907796 51,277,989,T/C0.13, 1.25(1.12–1.39) 7.161025
aRisk allele/reference allele.
bRAF, risk allele frequency in populations of European ancestry (EA) or HapMap CEU population, and in African Americans (AA) in this study. This is the allele associated
with increased risk in previous GWAS.
cAdjusted for age, study, the 1st10 eigenvalues and local ancestry at each risk locus.
dTest of trend (1-d.f.).
ePairwise correlation between the index signal and the best marker in African Americans in CEU or JPT (where indicated) in 1000 Genomes Project (March 2010 release).
fIndex signal reported in Japanese. RAFs and r2based on Japanese data  or JPT in 1000 Genomes.
hBest marker or index marker in AA is extremely rare or monomorphic in YRI.
ir2of rs3760722 and rs2735839 in YRI is 0.24.
jNo SNP selected in stepwise procedure.
kEstimated in HapMap JPT/CHB.
Genetics of Prostate Cancer in African Americans
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Table 2. Associations with risk variants at 8q24 in African Americans.
African Americans (3,425 cases, 3,290 controls)
Regiona, Position Marker, Allelesb
RAFc(EA/AA)OR (95% CI)d
OR (95% CI)
1, 127,993,841 rs12543663, C/A0.31/0.15 0.89(0.80–0.99)0.028 0.91(0.82–1.02)0.100.07
1, 128,081,119 rs10086908, T/C0.70/0.75 1.13(1.04–1.22)4.561023
2, 128,162,479 rs1016343, T/C0.20/0.221.03(0.95–1.12) 0.51 1.02(0.94–1.11)0.68 0.03
2, 128,164,338 rs13252298, A/G0.70/0.931.09(0.93–1.27) 0.28 1.04(0.89–1.22)0.60 0.12
2, 128,173,525 rs13254738h, C/A 0.35/0.60 1.25(1.16–1.36)2.161028
2, 128,176,062rs6983561h, C/A0.04/0.44 1.29(1.19–1.39)5.6610210
3, 128,404,855 rs620861, G/A0.61/0.65 1.06(0.99–1.14) 0.111.07(0.99–1.15) 0.088 0.06
3, 128,410,090 rs16902104, T/C0.14/0.071.01(0.88–1.16) 0.880.97(0.84–1.12) 0.720.05
4, 128,482,487 rs6983267, G/T 0.51/0.88 1.24(1.09–1.42)1.561023
4, 128,510,352rs7000448h, T/C 0.36/0.621.11(1.02–1.20)0.0121.08(0.99–1.18) 0.0700.16
5, 128,600,871 rs11986220h, A/T 0.09/0.051.39(1.20–1.61) 1.561025
1.28(1.06–1.56) 0.011 0.42
5, 128,601,319rs10090154h, T/C0.09/0.13 1.22(1.10–1.35) 2.061024
Regiona, Position Marker, Allelesb
RAFc(EA/AA) OR (95% CI)d
OR (95% CI)
1,127,994,810rs7839365h, T/A 0.60/0.611.18(1.09–1.27) 1.761025
1,128,059,437 rs753228h, C/T0.96/0.951.41(1.18–1.68) 1.561024
2,128,162,723rs4871008h, C/T 0.57/0.671.19(1.10–1.28) 7.461026
2,128,173,119 rs1456315, T/C 0.28/0.531.23(1.15–1.33) 8.061029
2,128,200,973 rs10098156h, G/C0.90/0.88 1.26(1.11–1.44)4.961024
2,128,219,343rs6987409h, T/C0.0/0.15 1.42(1.28–1.57)1.8610211
4,128,528,307rs13282506h, G/A0.73/0.88 1.25(1.09–1.43)1.361023
5,128,589,355rs7812429h, A/G 0.06/0.08 1.31(1.15–1.48) 3.461025
5,128,640,941 rs4313118, T/C0.77/0.79 1.16(1.07–1.27) 6.261024
aRisk regions as defined in [1,2,7,10,13].
bRisk /reference alleles.
cRAF, risk allele frequency in populations of European ancestry [1,6 or HapMap CEU] and in African Americans (AA).
dAdjusted for age, study, the 1st10 eigenvalues and local ancestry for region 127.8–129.0 Mb (NCBI build 36).
eTest of trend (1-d.f.).
fFrom the multivariate model. OR adjusted for age, study, the 1st10 eigenvalues, local ancestry and all other 8q24 risk variants.
gThe proportion of the variance explained by the other SNPs.
hImputed (Rsq$0.76). rs445114 was not genotyped and could not be imputed .
iSNPs kept in stepwise procedure if p,0.001.
Figure 1. Risk Allele Frequencies in Europeans and African Americans. The distribution of risk allele frequencies (RAF) for the 49 index SNPs
(from Table 1 and Table 2) in Europeans (EA) and African Americans (AA). The variants are sorted based on the RAF in EAs.
Genetics of Prostate Cancer in African Americans
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needed to capture all common alleles in the genome. For each
region, stepwise regression was used with SNPs kept in the final
model based on aaor ab(results for each model are provided in
Among the SNPs correlated with the index signal in the GWAS
population, a more significantly associated marker was identified
at 12 regions. For 5 of these regions, the new marker showed only
a slightly more significant association than the index signal (,1
order of magnitude change in the p-value; Table 1). However, for
7 regions (2p24, 2p15, 3q21, 6q22, 8q21, 11q13, and 19q13), the
new marker appeared to capture risk more strongly than the index
signal in African Americans. The risk region at 3q21 is provided in
Figure 2 as an example. Here the index signal was not significantly
associated with risk in African Americans (rs10934853, OR=1.03,
95% CI, 0.95–1.03, p=0.43), with the most significantly
associated marker in African Americans located ,200 kb
centromeric from the index signal (rs7641133, OR=1.16, 95%
CI 1.08–1.25, p=1.061024). These two markers are strongly
correlated in Europeans (HapMap CEU, r2=0.91) but not in
Africans (HapMap YRI, r2=0.11; Table 1), which suggests that in
African Americans rs7641133 is a better proxy of the biologically
important allele and may better localize the true association. For
some of these regions, the size of the LD blocks differ in
populations of African ancestry compared with the GWAS
population and thus, may assist in localizing the functional allele
(Figure S1). Using a strict abof 5.661026for discovery of novel
risk variants we observed no evidence of a second independent
signal at any risk region. For variants identified as significantly
associated with risk (Table 1), odds ratios for homozygous carriers
were generally greater than for heterozygous carriers, which
provides support for their associations (Table S7).
We examined 12 risk variants at 8q24 that had been reported
previously to beassociated
[1,7,10,13,14,20] with 7 being statistically significant and posi-
tively associated with risk (p,0.05). The risk SNP BD11934905
 is not on the Illumina 1 M array and was not genotyped in
this study. In contrast with what has been reported in Europeans,
withprostate cancer risk
the risk allele for rs12543663 was observed to be significantly
inversely associated with risk in African Americans (OR=0.89,
p=0.028; Table 2). The RAFs for 8 of the 12 alleles are more
common in African Americans than Europeans, with the average
RAF being 0.46 in African Americans and 0.32 in Europeans. The
largest difference in RAFs between populations are noted with
variants rs13252298, rs13254738, rs6983561, rs6983267 and
rs7000448, which have RAFs that are .0.20 greater in African
Americans than in Europeans. When all 12 variants were included
in a multivariate model, only 5 remained nominally associated
with risk (Table 2). In African Americans, many of these index
signals were weakly correlated (Figure S2) and demonstrated
stronger multi-allelic correlations (Table 2), which suggests that
some variants may define similar haplotypes marking the same
biologically relevant variants in this population. No significant
association was observed with rs7008482 (OR=0.96, p=0.52,
computed using data included in the initial report ) or markers
of risk at 8q24 for cancers of the breast, bladder, ovary, or
leukemia (rs13281615: OR=1.03, p=0.48; rs9642880: OR=
1.07, p=0.13; rs10088218: OR=0.91, p=0.06; rs2456449:
OR=1.06, p=0.24) [25–28].
To identify markers at 8q24 that best capture risk in African
Americans we performed a stepwise analysis of 1,549 genotyped
and imputed SNPs spanning the established risk locus (127.8–
129.0 Mb). This region contained 132 SNPs with nominal p-
values,0.001 (Figure 3), and 9 common alleles with per allele
ORs of 1.16–1.42 (Table 2) defined the most parsimonious model.
Similarly to the previously reported risk variants at 8q24 four of
these markers are substantially more common in African
Americans than Europeans (average RAF difference=0.07). Eight
of these markers show some degree of correlation with the known
risk variants and thus are likely to be tagging the same functional
allele, albeit for 4 SNPs the correlations are quite weak in the CEU
Figure 2. 2 2Log P Plot for Common Alleles at the Chromosome
3q21 Prostate Cancer Risk Locus. The index signal (rs10934853) is
designated by a purple diamond. The r2shown is that in Europeans
from HapMap (CEU) in relation to rs10934853. 2Log P-values are those
observed in African Americans from logistic regression models adjusted
for age, study, global ancestry (the 1st10 eigenvectors) and local
ancestry. Circles are genotyped SNPs and squares are imputed SNPs.
Grey circles are SNPs not in HapMap (r2can not be estimated). The plot
was generate using LocusZoom .
Figure 3. 2 2Log P Plot for Common Alleles at 8q24 in African
Americans. 2Log P-values for alleles in the region 127.8–129.0 Mb in
African Americans from logistic regression models adjusted for age,
study, global ancestry (the 1st10 eigenvectors) and local ancestry.
Pairwise correlations in the HapMap YRI population are shown in
relation to rs6987404, which was the most significant marker in the
region (p=1.8610211). Circles are genotyped SNPs and squares are
imputed SNPs. Grey circles are SNPs not in HapMap (r2can not be
estimated). The lines below demarcate the five risk regions (R) as
defined in [1,2,7,10,13]. The plot was generate using LocusZoom .
The nine SNPs highlighted are from the stepwise analysis presented in
Genetics of Prostate Cancer in African Americans
PLoS Genetics | www.plosgenetics.org5 May 2011 | Volume 7 | Issue 5 | e1001387
and YRI populations (r2,0.2; Table S8) suggesting that they may
be marking independent risk variants. For example, SNP
rs6987409 (RAF=0.15), which is monomorphic in Europeans,
remains significantly associated with risk conditional on the 12
known risk alleles at 8q24 (OR=1.31, 95% CI, 1.16–1.47,
p=7.161026), which suggests that this SNP may be marking a
novel variant that is relevant in African Americans; rs6987409 was
the most significant marker in the region (Figure 3).
We next estimated the cumulative effect of all prostate cancer risk
alleles, and compared a summary risk score comprised of
unweighted counts of all GWAS reported risk alleles to a risk score
that included variants we identified as being associated with risk in
African Americans (Table 3). Using index signals from GWAS (see
Methods), the risk per allele was 1.08 (95% CI, 1.06–1.09;
p=6.0610226) and individuals in the top quartile of the risk allele
distribution were at 2-fold greater risk of prostate cancer compared
to those in the lowest quartile (Table 3). As expected, the risk score
was improved when utilizing the markers that we identified at the
known risk loci as being more relevant to African Americans
(OR=1.17 95% CI, 1.15–1.19; p=5.1610274), with risk for those
stratifying by first-degree family history of prostate cancer, risk was
of the risk score distribution (3.5% of the population) compared to
those without a family history and in the first quartile (Table 3). The
risk score was associated equally with risk for advanced (n=1,087)
and non-advanced (n=1,968) prostate cancer (case-only test:
OR=1.02, 95% CI, 1.00–1.05 phet=0.082).
Using this risk score, we estimate (see Methods) that in the
aggregate, all risk alleles tested explain approximately 11% of risk
in first-degree relatives of cases.
In this large study of prostate cancer risk in African American
men we tested 49 variants that had been reported primarily in
populations of European and Asian ancestry, and we were able to
replicate associations (at p#0.05) with roughly half of these
markers. We had adequate power (.80%) to detect relative risks
of the magnitude reported previously for the majority of risk
variants (although we realize that power was overestimated as the
effect estimates from the initial report may be inflated due to the
winner’s curse phenomenon .) Through fine-mapping, we
identified markers in many regions that were more strongly
associated with risk in African Americans than the index variant,
and thus, are likely to be better proxies of the biologically relevant
allele in this population. Our ability to detect associations in
African Americans with either the index signal or correlated
variants suggests that most loci contain a biologically relevant
allele that is not unique to the initial GWAS population. These
findings improve upon previous studies to replicate associations in
African Americans , efforts which included some of these same
studies, but in substantially smaller sample sizes for most variants
Within 12 regions, fine-mapping in African Americans revealed
a more significantly associated marker (with evidence over the
index signal being clearly greater at 7 loci). For some of the
regions, the signal in African Americans was located in a smaller
region of LD than that observed in the GWAS population which
should aid in localizing the functional variant(s). Confirmation of
these associations in the initial GWAS populations will be required
before they can be declared as proxies of the underlying functional
alleles; however in many cases, given their modest to strong
Table 3. The association of the total risk score with prostate cancer risk in African Americans.
Index Markers from
GWAS (n=40) Risk-associated Markers in African Americans (n=27)
Mean number of risk alleles in controls,
OR per allele (95% CI)a
First-Degree Family History
First-Degree Family History
Quartiles of Risk Allelesb
Q1n (cases/controls) 603/824441/834328/61066/92
OR(95% CI)1.0(ref.)1.0(ref.) 1.0(ref.) 1.19(0.83–1.72)
Q2 n (cases/controls)775/915 717/853 530/615122/69
OR(95% CI) 1.16(1.00–1.34)1.60(1.37–1.87)1.50(1.25–2.18) 3.00(2.14–4.22)
P-value 0.05 4.661029
Q3n (cases/controls)841/732 804/795601/598 128/69
OR(95% CI)1.55(1.33–1.80) 1.89(1.62–2.21)1.81(1.51–2.18) 2.94(2.10–4.12)
Q4 n (cases/controls)1206/8231463/8081046/591 258/87
OR(95% CI)2.02(1.75–2.33)3.51(3.02–4.07)3.33(2.79–3.97) 4.66(3.48–6.23)
aOdds ratios (and 95% confidence intervals) adjusted for age, study, and the 1st10 eigenvalues.
bQuartiles based on distribution in controls (cutpoints for 40 SNPs: 37.5, 40.0 and 42.7; 27 SNPs: 28.7, 30.9 and 32.8).
cInformation about family history of prostate cancer is available on 90% of cases and 84% of controls.
Genetics of Prostate Cancer in African Americans
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correlation, based on HapMap data, with the index signal in the
GWAS population, most markers are expected to be strongly
associated with risk. At each locus, fine-mapping was based on the
Illumina 1 M-Duo content supplemented with SNPs imputed
from Phase 2 HapMap (CEU/YRI), which is expected to provide
good coverage of the vast majority of common alleles in the
admixed African American population. Of the ,1.5 million
common SNPs (MAF$0.05) in the HapMap YRI population that
we did not genotype, we were able to impute ,1.4 million with
Rsq$0.8. Our inability to detect associations at 10 regions
(p.0.05 for an index signal and p.0.004 for a proxy) could be
due to low power, the functional allele being rare or non-existent
in African Americans and/or inadequate tagging in these specific
Because of limited LD, fine-mapping in African Americans is
thought to be an effective approach for localizing functional risk
alleles for common phenotypes as populations of African ancestry
are expected to have, on average, fewer alleles that are correlated
with a functional variant. Fine-mapping in multiple racial/ethnic
populations should prove to be even more powerful for isolating
these variants as only a subset SNPs that are correlated with the
functional allele in different populations will be similar. Thus,
conducting association testing across multiple populations should
narrow the subset of potentially functional alleles in a region. A
complete resource of genome-wide variation data from multiple
populations provided by the 1000 Genomes Project will assist in
further interrogating these risk loci and together with large-scale
association testing in diverse samples, will guide researchers in
defining the subset of alleles that are correlated with risk across
populations and hence are the most logical candidates for
A number of prostate cancer risk regions have been found to
harbor more than one risk variant (e.g. 8q24, 17q12 and 11q13)
[1,10,17,18]. Aside from 8q24, the search for independent
markers at known risk loci has been limited to populations of
European ancestry. Using a relatively strict threshold for declaring
significance (average a,5.661026), we observed no evidence of
association that is independent of the index signal. While
suggestive associations were observed at many loci, testing of
these variants in additional African American samples will be
needed to confirm these associations, followed by testing in other
populations to assess whether the associations may be limited to
The risk region at 8q24 is the strongest susceptibility locus for
prostate cancer that has been identified to date, with a number of
different risk variants having been reported in different popula-
tions [1,6,7,10,13,14]. We identified nine SNPs at 8q24 that best
captured the genetic risk in African Americans, including SNP
rs6987409  which is not observed in Europeans (or is present at
an extremely low frequency). Like the reported index signals at
8q24 (Table 2), many of these markers are more common in
African Americans than in Europeans (average RAF differ-
ence=0.07). This is in contrast to the index signals in regions
outside of 8q24 where the RAF average difference was only 0.03.
If the frequency of these 8q24 variants is a good correlate of the
frequency of the underlying biologically relevant alleles then some
of the variants in this region may to contribute to the excess risk of
prostate cancer in African Americans, as suggested previously
. A precise estimate of its contribution will only come once the
functional alleles have been found and we understand their
associations in the context of other genetic and environmental
factors (or host factors such as age).
The cumulative effects of GWAS-identified variants for
common cancers are not yet clinically informative for risk
prediction [15,16]. Until the functional alleles are identified and
their effects are accurately estimated, modeling of the genetic risk
will rely on markers that best capture risk at an established
susceptibility locus for a given population. Many of the markers we
identified at these risk loci in African Americans appear to provide
substantial improvement over the GWAS-identified variants in
defining those who are at greater risk of prostate cancer in this
population. However, as estimated with the index signals in
European populations , these alleles likely account for only a
small fraction of the familial risk of the disease (,10%) in African
Americans. Validation of this risk model in African Americans and
in other populations will be needed, as will incorporating novel risk
variants identified through this GWAS in African American men.
The Institutional Review Board at the University of Southern
California approved the study protocol.
Nine studies were genotyped as part of the GWAS of prostate
cancer in African American men. Below is a brief description of
The Multiethnic Cohort (MEC).
215,251 men and women aged 45–75 years at recruitment from
Hawaii and California . The cohort was assembled in 1993–
1996 by mailing a self-administered, 26-page questionnaire to
persons identified primarily through the driver’s license files.
Identification of incident cancer cases is by regular linkage with the
Hawaii Tumor Registry and the Los Angeles County Cancer
Surveillance Program; both NCI-funded Surveillance, Epide-
miology, and End Results registries. From the cancer registries,
information is obtained about stage and grade. Collection of
biospecimens from incident prostate cases began in California in
1995 and in Hawaii in 1997 and a biorepository was established
between 2001 and 2006 from 67,000 MEC participants. The
participation rates for providing a blood sample have been greater
than 60%. Through January 1, 2008 the African American case-
control study in the MEC included 1,094 cases and 1,096 controls.
The Southern Community Cohort Study (SCCS).
SCCS is a prospective cohort of African and non-African
Americans which during 2002–2009 enrolled approximately
86,000 residents aged 40–79 years across 12 southern states
. Recruitment occurred mainly at community health centers,
institutions providing basic health services primarily to the
medically uninsured, so that the cohort includes many adults of
lower income and educational status. Each study participant
completed a detailed baseline questionnaire, and nearly 90%
provided a biologic specimen (approximately 45% a blood sample
and 45% buccal cells). Follow-up of the cohort is conducted by
linkage to national mortality registers and to state cancer registries.
Included in this study are 212 incident African American prostate
cancer cases and a matched stratified random sample of 419
African American male cohort members without prostate cancer
at the index date selected by incidence density sampling.
The Prostate, Lung, Colorectal, and Ovarian Cancer
Screening Trial (PLCO).
The Prostate, Lung, Colorectal,
and Ovarian Cancer Screening Trial , is a randomized,
two-arm trial among men and women aged 55–74 years to
determine if screening reduced the mortality from these cancers.
Male participants randomized to the intervention arm underwent
prostate specific antigen (PSA) screening at baseline and annually
for 5 years and digital rectal examination at baseline and annually
The MEC includes
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for 3 years. Sequential blood samples were collected from
participants assigned to the screening arm; participation was
93% at the baseline blood draw (1993–2001). Buccal cell samples
were collected from participants in the control arm of the trial;
participation was about 85% for this component. Included in this
study are 286 African American prostate cancer cases and 269
controls without a history of prostate cancer, matched on age at
randomization and study year of the trial.
The Cancer Prevention Study II Nutrition Cohort (CPS-
The CPS-II Nutrition Cohort includes over 86,000 men and
97,000 women from 21 US states who completed a mailed
questionnaire in 1992 (aged 40–92 years at baseline) . Starting
in 1997, follow-up questionnaires were sent to surviving cohort
members every other year to update exposure information and to
ascertain occurrence of new cases of cancer; a .90% response rate
has been achieved for each follow-up questionnaire. From 1998–
2001, blood samples were collected in a subgroup of 39,376 cohort
members. To further supplement the DNA resources, during
2000–2001, buccal cell samples were collected by mail from an
additional 70,000 cohort members. Incident cancers are verified
through medical records, or through state cancer registries or
death certificates when the medical record can not be obtained.
Genomic DNA from 76 African American prostate cancer cases
and 152 age-matched controls were included in stage 1 of the scan.
Prostate Cancer Case-Control Studies at MD Anderson
University of Texas M.D. Anderson Cancer Center in the
Houston Metropolitan area since 1996. Cases were accrued
from six institutions in the Houston Medical Center and were not
restricted with respect to Gleason score, stage or PSA. Controls
were identified via random-digit-dialing or among hospital visitors
and they were frequency matched to cases on age and race.
Lifestyle, demographic, and family history data were collected
using a standardized questionnaire. These studies contributed 543
African American cases and 474 controls to this study .
Identifying Prostate Cancer Genes (IPCG).
study were patients 1) undergoing treatment for prostate cancer in
the Department of Urology at Johns Hopkins Hospital from 1999
to 2007; 2) undergoing treatment at the Sidney Kimmel
Comprehensive Cancer Center from 2003 to 2007; and 3)
outside referrals as part of the Hereditary Prostate Cancer Study
from 1990 to present. Blood was obtained from groups 2) and 3)
while DNA from normal tissue was obtained from group 1). Data
are available on age at diagnosis, race, pretreatment prostate-
specific antigen (PSA) values, clinical pathology values, and family
history. The control subjects were men undergoing disease
screening and were not thought to have prostate cancer on the
basis of a physical exam and a serum PSA value below 4 ng/ml.
Screenings were performed at the Johns Hopkins Applied Physics
Lab, at Bethlehem Steel in Baltimore, and at local African
American churches in East Baltimore . A total of 368 African
American cases and 172 controls contributed to stage 1.
The Los Angeles Study of Aggressive Prostate Cancer
The LAAPC is a population-based case-control study
of aggressive prostate among African Americans in Los Angeles
County . Cases were identified through the Los Angeles
County Cancer Surveillance Program rapid case ascertainment
system and eligible cases included African American men
diagnosed with a first primary prostate cancer between January
1, 1999 and December 31, 2003. Eligible cases also had either
tumor extension outside the prostate, metastatic prostate cancer in
sites other than prostate, or needle biopsy of the prostate with
Gleason grade 8 or higher, or Gleason grade 7 and tumor in more
Cases in this
than 2/3 of the biopsy cores. Controls were identified by a
neighborhood walk algorithm and were men never diagnosed with
prostate cancer, and were frequency matched to cases on age (65
years). For this study, genomic DNA was included for 296 cases
and 140 controls. We also included an additional 163 African
American controls from the MEC that were frequency matched to
cases on age.
Prostate Cancer Genetics Study (CaP Genes).
African American component of this study population comprised
160 men: 75 cases diagnosed with more aggressive prostate cancer
and 85 age-matched controls . All subjects were recruited and
frequency-matchedon the major
Cleveland, Ohio (i.e., the Cleveland Clinic, University Hospitals
of Cleveland, and their affiliates) between 2001 and 2004. The
cases were newly diagnosed with histologically confirmed disease:
Gleason score 7; tumor stage T2c; or a prostate-specific antigen
level .10 ng/ml at diagnosis. Controls were men without a
prostate cancer diagnosis who underwent standard annual medical
examinations at the collaborating medical institutions.
Case-Control Study of Prostate Cancer among African
Americans in Washington, DC (DCPC).
described as African American were recruited for several case-
control studies on genetic risk factors for prostate cancer between
the years 2001 and 2005 from the Division of Urology at Howard
University Hospital (HUH) in Washington, DC. Control subjects
unrelated to the cases and matched for age (65 years) were also
ascertained from the prostate cancer screening population of the
Division of Urology at HUH . These studies included 292
cases and 359 controls.
King County (Washington) Prostate Cancer Studies
The study population consists of participants from
one of two population-based case-control studies among residents
of King County, Washington [39,40]. Incident Caucasian and
African American cases with histologically confirmed prostate
cancer were ascertained from the Seattle-Puget Sound SEER
cancer registry during two time periods, 1993–1996 and 2002–
2005. Age-matched (5-year age groups) controls were men without
a self-reported history of being diagnosed with prostate cancer and
were identified using one-step random digit telephone dialing.
Controls were ascertained during the same time periods as the
cases. A total of 145 incident African American cases and 81
African American controls were included from these studies.
The Gene-Environment Interaction in Prostate Cancer
The Henry Ford Health System (HFHS)
recruited cases diagnosed with adenocarcinoma of the prostate of
Caucasian or African American race, less than 75 years of age, and
living in the metropolitan Detroit tri-county area . Controls
were randomly selected from the same HFHS population base
from which cases were drawn. The control sample was frequency
matched at a ratio of 3 enrolled cases to 1 control based on race
and five-year age stratum. In total, 637 cases and 244 controls
were enrolled between January 2002 and December 2004. Of
study enrollees, DNA for 234 African Americans cases and 92
controls were included in stage 1 of the scan.
Unrelated men self-
Genotyping of 7,123 samples from these studies (3,621 cases
and 3,502 controls) was conducted using the Illumina Infinium
1 M-Duo bead array at the University of Southern California and
the NCI Genotyping Core Facility (PLCO study). Following
genotyping samples were removed based on the following
exclusion criteria: 1) unknown replicates across studies (n=24,
none within studies); 2) call rates ,95% (n=126); 3) samples with
.10% mean heterozygosity on the X chromosome and/or ,10%
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mean intensity on the Y chromosome - we inferred 3 samples to be
XX and 6 to be XXY; 4) ancestry outliers (n=108, discussed
below), and; 5) samples that were related (n=141, discussed
below). To assess genotyping reproducibility we included 158
replicate samples; the average concordance rate was 99.99%
($99.3% for all pairs). Starting with 1,153,397 SNPs, we removed
SNPs with ,95% call rate, MAFs,1%, or .1 QC mismatch
based on sample replicates (n=105,411). The analysis included
1,047,986 SNPs among 3,425 cases and 3,290 controls.
probabilities of sharing 0, 1, and 2 alleles (Z=Z0, Z1, Z2) across
all possible pairs of samples to determine individuals who were
likely to be related to others within and across studies. We
identified 167 pairs of related subjects (MZ twin, parent-offspring
pairs, full and half-sibling pairs), based on the values of their
observed probability vector Z being within 1 SD of the expected
values of Z for their respective relationship. The criterion for
removal was such that individuals that were connected with a
higher number of pairs were chosen for removal. In all other cases,
one of the two members was randomly selected for removal. A
total of 141 subjects were removed.
Global ancestry estimation.
was used to calculate eigenvectors that explained genetic
differences in ancestry among samples in the study . The
program included data from both HapMap Phase 3 populations
and our study, so that comparisons to reference populations of
known ethnicity could be made. An individual was subject to
filtering from the analysis if his value along eigenvector 1 or 2 was
outside of 4 SDs of the mean of each respective eigenvector. We
identified 108 individuals who met this criterion. Eigenvector 1
was highly correlated (r=0.997, p,1610216) with percentage of
European ancestry, estimated in HAPMIX . Together the top
10 eigenvectors (used in the analysis) explain 21% of the global
genetic variability among subjects.
Local ancestry estimation.
participant, local ancestry was defined as the estimated number of
European chromosomes (continuous between 0–2) carried by the
participant, estimated via the HAPMIX program . To
summarize local ancestry at each region, for each individual we
averaged across all local ancestry estimates that were within the
start and end points of the region (Table S5). We used this average
value as an additional covariate in the risk analyses.
In order to generate a dataset suitable for
fine-mapping, we carried out genome-wide imputation using the
software MACH . Phased haplotype data from the founders of
the CEU (CEPH) and YRI (Yoruba) HapMap Phase 2 samples
were used to infer LD patterns in order to impute ungenotyped
markers. The Rsq metric, defined as the observed variance divided
by the expected variance, provides a measure of the quality of the
imputation at any SNP, and was used as a threshold in determining
which SNPs to filter from analysis (Rsq,0.3). Of the 1,539,328
common SNPs (MAF$0.05) in the YRI population in HapMap
Phase 2, we could impute 1,392,294 (90%) with Rsq$0.8. For all
imputed SNPs presented in the Results and Tables reported herein,
the average Rsq was 0.92 (estimated in MACH).
For each typed and imputed SNP, odds
ratios (OR) and 95% confidence intervals (95% CI) were estimated
using unconditional logistic regression adjusting for age at
diagnosis (or age at the reference date for controls), study, the
first 10 eigenvalues and local ancestry. For each SNP, we tested for
allele dosage effects through a 1 d.f. Wald chi-square trend test.
We used PLINK to calculate the
The EIGENSTRAT software
At each locus and for each
We fine-mapped each risk locus in search of 1) a better marker
of the index signal in African Americans, and; 2) a novel signal
that is independent of the index signal. These analyses included
SNPs (genotyped and imputed) spanning 250 kb upstream and
250 kb downstream of each index signal. If the index signal was
contained within an LD block (based on the D9statistic) of
.250 kb, then the region was extended to include the entire
region of LD. Stepwise regression was performed by region to
select the most informative risk variants as discussed below, in
models adjusted for age, study, global ancestry (the 1steigenvector)
and local ancestry. In the stepwise regression we preserved the
original sample size by using the mean genotype of typed subjects
in place of ‘‘no-calls’’ for SNPs with ,100% genotyping
Within each known risk locus, it is expected that markers that
are associated with risk in African Americans will be correlated
with the index signal reported in Europeans. Thus, we identified
and tested SNPs that are correlated (r2.0.2) with the index signals
in Europeans in HapMap (CEU population). Because these
variants are not independent and there is a high prior probability
that signals exist among such variants, we applied a lenient criteria
for keeping them in the stepwise regression. The average number
of tags to capture (r2.0.8) these SNPs in each region was used as a
correction factor, as they define the number of independent tests
(p,0.004). For all of the remaining markers that were not
correlated with the index signal (in Europeans), we applied a more
stringent a level for defining statistical significance. In each risk
region, we determined the number of tag SNPs needed to capture
all common alleles (MAF.0.05, with r2.0.8) in the YRI
population in Phase 2 HapMap using single and multi-marker
tests. An a of 0.05/the total number of tags was applied to assess
statistical significance for any putative novel, independent signal in
each region (p,5.661026). For the correlated SNPs we had 80%
power to detect an OR of 1.17 per copy for a 20% risk allele,
whereas for the novel SNPs the detectable OR for such an allele
increased to 1.26 per copy. A similar stepwise analysis was also
performed at 8q24 (127.8–129.0 Mb) for SNPs with nominal p-
values,0.05, keeping SNPs if p,0.001 in the multivariate model.
This choice of p-value reflects a balance between the need to
correct for multiple comparisons and the prior knowledge that this
region harbors multiple independent risk alleles for prostate
cancer. For SNPs in the 8q24 region we had 80% power to detect
an OR of 1.19 per copy for a 20% risk allele. We tested
heterogeneity of effect by study for all 76 SNPs presented in
Table 1 and Table 2 and we observed 5 significant associations
(p,0.05, 3.6 expected) and only 1 at p,0.01 (rs7000448 at 8q24,
We modeled the cumulative genetic risk of
prostate cancer using the risk variants reported in previous GWAS
(total=40). For regions outside of 8q24 with multiple correlated
variants, we selected the SNP with the largest OR in African
Americans. At 8q24 we used the seven variants reported in Al
Olama et al. . We compared the results to a model of the SNPs
found to be significantly associated with risk in African Americans,
which included the index signals if nominally associated with risk
in African Americans (p#0.05) as well as SNPs identified from the
stepwise procedures at all loci including 8q24 (total=27). More
specifically, in each case we summed the number of risk alleles for
each individual and estimated the odds ratio per allele for this
aggregate unweighted allele count variable as an approximate risk
score appropriate for unlinked variants with independent effects of
approximately the same magnitude for each allele. For individuals
missing genotypes for a given SNP, we assigned the average
number of risk alleles (26 risk allele frequency) to replace the
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missing value for that SNP. To address the independence
assumption, we compared the betas for each SNP with the betas
obtained when all SNPs were included in the same model. We
found remarkable consistency in the betas, which supports their
associations as being independent (Table S9). We also stratified the
risk score analysis by first-degree family history of prostate cancer.
We tested for differences in the effect of the risk score by disease
severity (advanced disease defined as Gleason 8–10 and/or non-
localized stage vs non-advanced disease defined as Gleason#7 and
Heritability explained by the score.
how much of the familial risk of prostate cancer is explained by the
known risk alleles as summarized in the improved risk score. In
this study, a first-degree family history of prostate cancer is
associated with a relative risk of 1.55 (95% CI, 1.32–1.81). Making
the simplifying assumption that all risk alleles are inherited
independently then the correlation between the risk allele count
for two first-degree relatives will be equal to 0.5 (i.e. will equal 1/2
the probability of sharing one allele IBD+the probability of sharing
two alleles IBD). Making the further assumption that the number
of risk alleles is distributed as approximately normal with
mean=30.66 and standard deviation 3.07 alleles in the
population (estimated among African American controls) and
that in cases the mean is 32.13 alleles with roughly the same
standard deviation (3.08), we can approximate the mean number
of alleles in individuals of unknown prostate cancer status, but
each of whom has a single first-degree relative (brother or father)
with the disease as 30.66(1–0.52)+32.13(0.52)=31.03. Since this is
just 0.37 more alleles than is expected in the control population
overall we see that the relative odds of prostate cancer for a man
witha brotheror fatherwith
exp(log(1.17)*0.37)=1.06 higher than an unselected subject (i.e.
one not selected on the basis of disease in a first-degree relative).
Compared to the approximately 1.55-fold increase in relative risk,
this riskscore mayonly
(1.5521)6100%] of risk in first-degree relatives of cases, which
indicates that many more alleles are required to explain familial
aggregation in the African American population.
We estimated crudely
regions in the GWAS population and Yorubans (YRI).
Found at: doi:10.1371/journal.pgen.1001387.s001 (2.61 MB
Linkage disequilibrium plots of prostate cancer risk
8q24 in African Americans estimated in 941 African Americans in
Found at: doi:10.1371/journal.pgen.1001387.s002 (0.04 MB
Pairwise correlation (r2) of known risk variants at
stage 1 of the GWAS of prostate cancer in African Americans.
Found at: doi:10.1371/journal.pgen.1001387.s003 (0.02 MB
Descriptive characteristics of the 11 studies included in
variants in African American.
Found at: doi:10.1371/journal.pgen.1001387.s004 (0.05 MB
Power to detect associations with the known risk
index signal(s) at each risk locus and prostate cancer risk.
Found at: doi:10.1371/journal.pgen.1001387.s005 (0.02 MB
The association of local ancestry surrounding the
cancer (3,425 cases, 3,290 controls) adjusted for global ancestry.
Found at: doi:10.1371/journal.pgen.1001387.s006 (0.02 MB
Associations with established risk variants for prostate
Found at: doi:10.1371/journal.pgen.1001387.s007 (0.03 MB
Information about the 27 regions fine-mapped (not
(not including 8q24).
Found at: doi:10.1371/journal.pgen.1001387.s008 (0.02 MB
Results of the stepwise procedure in each risk region
prostate cancer risk regions that were found to be nominally
associated with risk in African Americans.
Found at: doi:10.1371/journal.pgen.1001387.s009 (0.02 MB
Associations by genotype class for SNPs in known
Africans and known risk variants at 8q24.
Found at: doi:10.1371/journal.pgen.1001387.s010 (0.02 MB
Correlations (r2) between risk markers in African
Found at: doi:10.1371/journal.pgen.1001387.s011 (0.02 MB
Independence of markers utilized in risk modeling.
We thank Dr. David Van Den Berg and Mr. Christopher Edlund from the
USC Genomics Core for their technical and informatics assistance. The
authors thank Drs. Christine Berg and Philip Prorok, Division of Cancer
Prevention, NCI; the screening center investigators and staff of the PLCO
Cancer Screening Trial; Mr. Thomas Riley and staff at Information
Management Services, Inc.; and Ms. Barbara O’Brien and staff at Westat,
Inc. for their contributions to the PLCO Cancer Screening Trial. We also
acknowledge the technical support of Marta Gielzak and Guifang Yan.
Conceived and designed the experiments: CAH. Performed the experi-
ments: SJC LP. Analyzed the data: CAH GKC XS PW DOS. Contributed
reagents/materials/analysis tools: WJB SSS SIB RK BR WBI SAI JS
WRD JSW SJC SK LBS YY CND MJT AM GC KRM KMW LLM LNK
BEH. Wrote the paper: CAH.
1. Al Olama AA, Kote-Jarai Z, Giles GG, Guy M, Morrison J, et al. (2009)
Multiple loci on 8q24 associated with prostate cancer susceptibility. Nat Genet
2. Amundadottir LT, Sulem P, Gudmundsson J, Helgason A, Baker A, et al. (2006)
A common variant associated with prostate cancer in European and African
populations. Nat Genet 38: 652–658.
3. Eeles RA, Kote-Jarai Z, Al Olama AA, Giles GG, Guy M, et al. (2009)
Identification of seven new prostate cancer susceptibility loci through a genome-
wide association study. Nat Genet 41: 1116–1121.
4. Eeles RA, Kote-Jarai Z, Giles GG, Olama AA, Guy M, et al. (2008) Multiple
newly identified loci associated with prostate cancer susceptibility. Nat Genet 40:
5. Freedman ML, Haiman CA, Patterson N, McDonald GJ, Tandon A, et al.
(2006) Admixture mapping identifies 8q24 as a prostate cancer risk locus in
African-American men. Proc Natl Acad Sci U S A 103: 14068–14073.
6. Gudmundsson J, Sulem P, Gudbjartsson DF, Blondal T, Gylfason A, et al.
(2009) Genome-wide association and replication studies identify four variants
associated with prostate cancer susceptibility. Nat Genet 41: 1122–1126.
Genetics of Prostate Cancer in African Americans
PLoS Genetics | www.plosgenetics.org10 May 2011 | Volume 7 | Issue 5 | e1001387
7. Gudmundsson J, Sulem P, Manolescu A, Amundadottir LT, Gudbjartsson D, Download full-text
et al. (2007) Genome-wide association study identifies a second prostate cancer
susceptibility variant at 8q24. Nat Genet 39: 631–637.
8. Gudmundsson J, Sulem P, Rafnar T, Bergthorsson JT, Manolescu A, et al.
(2008) Common sequence variants on 2p15 and Xp11.22 confer susceptibility to
prostate cancer. Nat Genet 40: 281–283.
9. Gudmundsson J, Sulem P, Steinthorsdottir V, Bergthorsson JT, Thorleifsson G,
et al. (2007) Two variants on chromosome 17 confer prostate cancer risk, and
the one in TCF2 protects against type 2 diabetes. Nat Genet 39: 977–983.
10. Haiman CA, Patterson N, Freedman ML, Myers SR, Pike MC, et al. (2007)
Multiple regions within 8q24 independently affect risk for prostate cancer. Nat
Genet 39: 638–644.
11. Takata R, Akamatsu S, Kubo M, Takahashi A, Hosono N, et al. (2010)
Genome-wide association study identifies five new susceptibility loci for prostate
cancer in the Japanese population. Nat Genet 42: 751–754.
12. Thomas G, Jacobs KB, Yeager M, Kraft P, Wacholder S, et al. (2008) Multiple
loci identified in a genome-wide association study of prostate cancer. Nat Genet
13. Yeager M, Chatterjee N, Ciampa J, Jacobs KB, Gonzalez-Bosquet J, et al. (2009)
Identification of a new prostate cancer susceptibility locus on chromosome 8q24.
Nat Genet 41: 1055–1057.
14. Yeager M, Orr N, Hayes RB, Jacobs KB, Kraft P, et al. (2007) Genome-wide
association study of prostate cancer identifies a second risk locus at 8q24. Nat
Genet 39: 645–649.
15. Gail MH (2009) Value of adding single-nucleotide polymorphism genotypes to a
breast cancer risk model. J Natl Cancer Inst 101: 959–963.
16. Wacholder S, Hartge P, Prentice R, Garcia-Closas M, Feigelson HS, et al.
(2010) Performance of common genetic variants in breast-cancer risk models.
N Engl J Med 362: 986–993.
17. Sun J, Zheng SL, Wiklund F, Isaacs SD, Purcell LD, et al. (2008) Evidence for
two independent prostate cancer risk-associated loci in the HNF1B gene at
17q12. Nat Genet 40: 1153–1155.
18. Zheng SL, Stevens VL, Wiklund F, Isaacs SD, Sun J, et al. (2009) Two
independent prostate cancer risk-associated Loci at 11q13. Cancer Epidemiol
Biomarkers Prev 18: 1815–1820.
19. Waters KM, Le Marchand L, Kolonel LN, Monroe KR, Stram DO, et al.
(2009) Generalizability of associations from prostate cancer genome-wide
association studies in multiple populations. Cancer Epidemiol Biomarkers Prev
20. Jia L, Landan G, Pomerantz M, Jaschek R, Herman P, et al. (2009) Functional
enhancers at the gene-poor 8q24 cancer-linked locus. PLoS Genet 5: e1000597.
21. Kote-Jarai Z, Easton DF, Stanford JL, Ostrander EA, Schleutker J, et al. (2008)
Multiple novel prostate cancer predisposition loci confirmed by an international
study: the PRACTICAL Consortium. Cancer Epidemiol Biomarkers Prev 17:
22. Rafnar T, Sulem P, Stacey SN, Geller F, Gudmundsson J, et al. (2009) Sequence
variants at the TERT-CLPTM1L locus associate with many cancer types. Nat
Genet 41: 221–227.
23. Xu J, Zheng SL, Isaacs SD, Wiley KE, Wiklund F, et al. (2010) Inherited genetic
variant predisposes to aggressive but not indolent prostate cancer. Proc Natl
Acad Sci U S A 107: 2136–2140.
24. Robbins C, Torres JB, Hooker S, Bonilla C, Hernandez W, et al. (2007)
Confirmation study of prostate cancer risk variants at 8q24 in African Americans
identifies a novel risk locus. Genome Res 17: 1717–1722.
25. Crowther-Swanepoel D, Broderick P, Di Bernardo MC, Dobbins SE, Torres M,
et al. (2010) Common variants at 2q37.3, 8q24.21, 15q21.3 and 16q24.1
influence chronic lymphocytic leukemia risk. Nat Genet 42: 132–136.
26. Easton DF, Pooley KA, Dunning AM, Pharoah PD, Thompson D, et al. (2007)
Genome-wide association study identifies novel breast cancer susceptibility loci.
Nature 447: 1087–1093.
27. Goode EL, Chenevix-Trench G, Song H, Ramus SJ, Notaridou M, et al. (2010)
A genome-wide association study identifies susceptibility loci for ovarian cancer
at 2q31 and 8q24. Nat Genet.
28. Kiemeney LA, Thorlacius S, Sulem P, Geller F, Aben KK, et al. (2008)
Sequence variant on 8q24 confers susceptibility to urinary bladder cancer. Nat
Genet 40: 1307–1312.
29. Xiao R, Boehnke M (2009) Quantifying and correcting for the winner’s curse in
genetic association studies. Genet Epidemiol 33: 453–462.
30. Chang BL, Spangler E, Gallagher S, Haiman CA, Henderson BE, et al. (2010)
Validation of Genome-Wide Prostate Cancer Associations in Men of African
Descent. Cancer Epidemiol Biomarkers Prev.
31. Xu J, Kibel AS, Hu JJ, Turner AR, Pruett K, et al. (2009) Prostate cancer risk
associated loci in African Americans. Cancer Epidemiol Biomarkers Prev 18:
32. Kolonel LN, Henderson BE, Hankin JH, Nomura AM, Wilkens LR, et al. (2000)
A multiethnic cohort in Hawaii and Los Angeles: baseline characteristics.
Am J Epidemiol 151: 346–357.
33. Signorello LB, Hargreaves MK, Steinwandel MD, Zheng W, Cai Q, et al. (2005)
Southern community cohort study: establishing a cohort to investigate health
disparities. J Natl Med Assoc 97: 972–979.
34. Gohagan JK, Prorok PC, Hayes RB, Kramer BS (2000) The Prostate, Lung,
Colorectal and Ovarian (PLCO) Cancer Screening Trial of the National Cancer
Institute: history, organization, and status. Control Clin Trials 21: 251S–272S.
35. Calle EE, Rodriguez C, Jacobs EJ, Almon ML, Chao A, et al. (2002) The
American Cancer Society Cancer Prevention Study II Nutrition Cohort:
rationale, study design, and baseline characteristics. Cancer 94: 2490–2501.
36. Strom SS, Gu Y, Zhang H, Troncoso P, Babaian RJ, et al. (2004) Androgen
receptor polymorphisms and risk of biochemical failure among prostatectomy
patients. Prostate 60: 343–351.
37. Ingles SA, Coetzee GA, Ross RK, Henderson BE, Kolonel LN, et al. (1998)
Association of prostate cancer with vitamin D receptor haplotypes in African-
Americans. Cancer Res 58: 1620–1623.
38. Liu X, Plummer SJ, Nock NL, Casey G, Witte JS (2006) Nonsteroidal
antiinflammatory drugs and decreased risk of advanced prostate cancer:
modification by lymphotoxin alpha. Am J Epidemiol 164: 984–989.
39. Agalliu I, Salinas CA, Hansten PD, Ostrander EA, Stanford JL (2008) Statin use
and risk of prostate cancer: results from a population-based epidemiologic study.
Am J Epidemiol 168: 250–260.
40. Stanford JL, Wicklund KG, McKnight B, Daling JR, Brawer MK (1999)
Vasectomy and risk of prostate cancer. Cancer Epidemiol Biomarkers Prev 8:
41. Rybicki BA, Neslund-Dudas C, Nock NL, Schultz LR, Eklund L, et al. (2006)
Prostate cancer risk from occupational exposure to polycyclic aromatic
hydrocarbons interacting with the GSTP1 Ile105Val polymorphism. Cancer
Detect Prev 30: 412–422.
42. Price AL, Patterson NJ, Plenge RM, Weinblatt ME, Shadick NA, et al. (2006)
Principal components analysis corrects for stratification in genome-wide
association studies. Nat Genet 38: 904–909.
43. Price AL, Tandon A, Patterson N, Barnes KC, Rafaels N, et al. (2009) Sensitive
detection of chromosomal segments of distinct ancestry in admixed populations.
PLoS Genet 5: e1000519. doi:10.1371/journal.pgen.1000519.
44. Li Y, Willer C, Sanna S, Abecasis G (2009) Genotype imputation. Annu Rev
Genomics Hum Genet 10: 387–406.
45. Pruim RJ, Welch RP, Sanna S, Teslovich TM, Chines PS, et al. (2010)
LocusZoom: regional visualization of genome-wide association scan results.
Bioinformatics 26: 2336–2337.
Genetics of Prostate Cancer in African Americans
PLoS Genetics | www.plosgenetics.org 11 May 2011 | Volume 7 | Issue 5 | e1001387