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Polygenic risk scores and air pollutants associated with increased lung cancer riskGenetic Scores and Air Pollution Linked to Lung Cancer Risk

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Key Takeaway
Note that polygenic risk scores and air pollutants are associated with increased lung cancer risk in screening populations.

This randomized controlled trial analyzed a cohort of 7,364 individuals from the NELSON lung cancer screening population to evaluate risk stratification using polygenic risk scores (PRS) and ambient air pollutants (AAP). The study assessed two specific PRS models: PRS-McKay and PRS-Byun.

Results indicated that both PRS-McKay (OR 1.22; 95% CI [1.08-1.37]) and PRS-Byun (OR 1.28; 95% CI [1.13-1.44]) were associated with increased lung cancer risk per standard deviation. Furthermore, both models showed a significant association with lung cancer-specific mortality (OR 1.24; 95% CI [1.05-1.47] for both). Conversely, neither PRS model was significantly associated with non-lung cancer mortality.

Environmental factors also showed associations: PM2.5 was associated with lung cancer (OR 1.11; 95% CI [1.01-1.22]), while PM10 and ultra-fine particles were both associated with adenocarcinoma (OR 1.16; 95% CI [1.01-1.32] and [1.04-1.30] respectively). When PRS and AAP were added to traditional factors like pack-years, age, and sex, the discriminative ability for lung cancer improved from an AUC of 0.643 to 0.659.

Safety data were not reported. The study notes that these are associations only; the findings do not prove causality. These metrics may help refine selection toward individuals at higher risk of dying from lung cancer specifically.

How this fits prior evidence

How this fits prior evidence: This finding addresses a gap in identifying specific high-risk subgroups within lung cancer populations. While previous coverage noted that AI models for lung nodule malignancy classification show 88% sensitivity and 75% specificity, the current study provides an alternative risk stratification method using genetic and environmental factors to identify individuals at higher risk of mortality.

Researchers analyzed data from 7,364 people in a lung cancer screening cohort. They looked at how genetic markers, known as polygenic risk scores, and common air pollutants like particulate matter affect the risk of developing lung cancer and dying from the disease.

The study found that higher genetic risk scores were linked to an increased likelihood of lung cancer and lung cancer-specific deaths. Additionally, exposure to certain air pollutants was associated with higher rates of lung cancer and specific types of lung cancer, such as adenocarcinoma. These factors combined with age and smoking history slightly improved the ability to identify who is at highest risk.

It is important to note that this study shows a link between these factors and lung cancer, but it does not prove that one causes the other. Because this was an observational analysis of a specific group, the results may not apply to everyone. These findings suggest that genetic scores could eventually help doctors better identify patients who need more intensive monitoring.

What this means for you:
Genetic risk scores and air pollution are linked to higher lung cancer risk in certain populations.

Common questions

What role do genetics play in lung cancer risk?

The study found that two different polygenic risk scores were linked to an increased risk of lung cancer. Specifically, the PRS-McKay score showed an odds ratio of 1.22 and the PRS-Byun score showed an odds ratio of 1.28 for lung cancer. Both scores were also associated with a higher risk of death specifically from lung cancer.

How does air pollution affect lung cancer risk?

The study found that exposure to particulate matter (PM2.5) was linked to an increased risk of lung cancer. Additionally, larger particles (PM10) and ultra-fine particles were both associated with a higher risk of adenocarcinoma, which is a specific type of lung cancer.

Can these factors help doctors identify high-risk patients?

When genetic scores and air pollution data were added to traditional factors like age and smoking history, the ability to distinguish who has lung cancer improved slightly. This suggests that these factors might eventually help doctors better identify individuals at a higher risk of dying from lung cancer.

Study Details

Study typeRct
Sample sizen = 7,364
EvidenceLevel 2
PublishedJul 2026
View Original Abstract ↓
Background: Randomized controlled trials have shown that computed tomographic (CT) screening reduces lung cancer mortality. Improved identification of at-risk groups, by leveraging non-smoking risk factors, could help refine screening selection. Aim: To evaluate polygenic risk scores (PRSs) and ambient air pollution (AAP) exposure for risk stratification in the NELSON lung cancer screening cohort. Methods: Two PRSs (PRS-McKay/PRS-Byun) and several AAPs (including nitrogen dioxide, ozone, and particulate matter [PM]) were assessed in the NELSON lung cancer screening trial (N=7,364). PRSs were validated in the Rotterdam Study (N=11,493). Associations with lung cancer, mortality, screening results, and discriminative ability to distinguish lung cancer were evaluated. Results: PRS-McKay and PRS-Byun were associated with lung cancer (odds ratio [OR] per SD [95%CI]: 1.22 [1.08-1.37] and 1.28 [1.13-1.44], respectively) and lung cancer-specific mortality (OR [95%CI]: 1.24 [1.05-1.47], for both), but not with non-lung cancer mortality (OR [95%CI]: 1.01 [0.94-1.10] and 1.03 [0.95-1.12], respectively). Exposure to PM2.5 was associated with lung cancer (OR [95%CI]: 1.11 [1.01-1.22]). PM constituents were associated with adenocarcinoma, particularly PM10 (OR [95%CI]: 1.16 [1.01-1.32]) and ultra-fine particles (OR [95%CI]: 1.16 [1.04-1.30]). PRS and AAP added modestly to the discriminative ability for lung cancer on top of pack-years, age, and sex (area under the curve [95%CI]: 0.659 [0.624-0.695] vs. 0.643 [0.608-0.679]). Conclusions: PRSs and exposure to PM were associated with lung cancer in a high-risk screening population. The primary potential of PRSs may reside in refining lung cancer screening selection toward individuals at higher risk of dying from lung cancer specifically.
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