Polygenic Scores in Epidemiology: Risk Prediction, Etiology, and Clinical Utility

Genes account for a significant proportion of the risk for most common diseases. The genome-wide association scan (GWAS) era of genetic epidemiology has generated a massive amount of data, revolutionized our thinking on the genetic architecture of common diseases and positioned the field to realistically consider risk prediction for common polygenic diseases, such as non-familial cancers, and autoimmune, cardiovascular and psychiatric diseases. Polygenic scoring is an approach that shows promise for understanding the polygenic contribution to common human diseases. This is an approach typically relying on genome-wide SNP data, where a set of SNPs identified in a discovery GWAS are used to construct composite polygenic scores. These scores are then used in additional samples for association testing or risk prediction. This review summarizes the extant literature on the use, power, and accuracy of polygenic scores in studies of the etiology of disease and the promise for disease risk prediction.