Abstract Mosaic loss of the Y chromosome (mLOY), a type of clonal hematopoiesis, is the most frequent chromosomal alteration observed in leukocytes of aging men. mLOY is a putative biomarker of genomic instability with evidence of associations with risk of some solid tumors, but more studies are needed to refine associations and identify potential mechanisms for cancer risk. Prostate cancer (PCa), the most common non-cutaneous cancer in males, is also associated with aging. To further investigate potential relationships between mLOY and PCa, we examined DNA derived from leukocytes of male participants in two large biobanks: the UK Biobank (UKBB; N = 210,103) and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial (PLCO, N = 26,795). Of the 236,898 male participants without previous cancer diagnosis, 14,253 (6.0%) were diagnosed with incident PCa after DNA collection. High-density genotyping array data collected during the studies were used to create virtual karyotypes for detecting mLOY in whole blood samples utilizing a phase-based detection method in MoChA software. Analyses were restricted to men without cancer at genotyping and multivariable regression models were adjusted for age, smoking status, and genetic similarity. Men with detectable mLOY were older (mean = 62 vs 56 years) and more likely to be smokers (14.8% vs 9.7%) than men without mLOY. A total of 3,848 (27.0%) men with PCa and 42,835 (19.2%) men free of PCa had detectable mLOY. mLOY clonal fraction ranged from 0.01% to 72.1% of total leukocytes. 18.7% of PCa cases and 13.6% of men free of PCa had high clonal fraction mLOY, defined as greater than 10% of leukocytes with mLOY. Fixed effect meta-analysis of multivariable models from UKBB and PLCO produced evidence for a positive association between mLOY in leukocytes and incident PCa; (Odds Ratio (OR) = 1.062, 95% Confidence Interval (CI) [1.020, 1.107], P-Value (p) = 0.004). The effect estimate was the same in men with low clonal fraction of mLOY (OR = 1.062, 95% CI [1.012, 1.113], p = 0.014) and men with high clonal fraction of mLOY (OR = 1.065, 95% CI [0.998, 1.137], p = 0.057). Age at PCa diagnosis was not associated with mLOY or the clonal fraction of mLOY. A sub-analysis of separate participants from PLCO with mLOY detected in buccal cells (n = 18,011) also showed a small positive effect between mLOY and PCa risk, but the relationship did not reach statistical significance (OR = 1.036, 95% CI [0.877, 1.224], p = 0.673)). Our investigation of the relationship between mLOY and PCa in two large prospective studies provides additional evidence for an association between mLOY detected in the blood and increased PCa risk, meriting additional studies of potential biologic mechanisms underlying the relationship. Citation Format: Rebecca L. Kelly, Weiyin Zhou, Kara M. Barnao, Corey D. Young, Aubrey K. Hubbard, Sairah M. Khan, Wen-Yi Huang, Stephen J. Chanock, Mitchell J. Machiela. Mosaic loss of the Y chromosome is associated with prostate cancer risk [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3430.
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