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Christopher Haiman, Bogdan Pasaniuc, David Reich and colleagues report a major role for low-frequency variation in the risk for prostate cancer. They show that alleles with >1% minor allele frequency contribute an order of magnitude more to risk for prostate cancer than these alleles do to overall genetic variation. We report targeted sequencing of 63 known prostate cancer risk regions in a multi-ancestry study of 9,237 men and use the data to explore the contribution of low-frequency variation to disease risk. We show that SNPs with minor allele frequencies (MAFs) of 0.1–1% explain a substantial fraction of prostate cancer risk in men of African ancestry. We estimate that these SNPs account for 0.12 (standard error (s.e.) = 0.05) of variance in risk (∼42% of the variance contributed by SNPs with MAF of 0.1–50%). This contribution is much larger than the fraction of neutral variation due to SNPs in this class, implying that natural selection has driven down the frequency of many prostate cancer risk alleles; we estimate the coupling between selection and allelic effects at 0.48 (95% confidence interval [0.19, 0.78]) under the Eyre-Walker model. Our results indicate that rare variants make a disproportionate contribution to genetic risk for prostate cancer and suggest the possibility that rare variants may also have an outsize effect on other common traits.

Although genome-wide association studies (GWAS) have found more than a hundred common susceptibility alleles for prostate cancer, the GWAS reported variants jointly explain only 33% of risk to siblings, leaving the majority of the familial risk unexplained. We use targeted sequencing of 63 known GWAS risk regions in 9,237 men from four ancestries (African, Latino, Japanese, and European) to explore the role of low-frequency variation in risk for prostate cancer. We find that the sequenced variants explain significantly more of the variance in the trait than the known GWAS variants, thus showing that part of the missing familial risk lies in poorly tagged causal variants at known risk regions. We report evidence for genetic heterogeneity in SNP effect sizes across different ancestries. We also partition heritability by minor allele frequency (MAF) spectrum using variance components methods, and find that a large fraction of heritability (0.12, s.e. 0.05; 95% CI [0.03, 0.21]) is explained by rare variants (MAF<0.01) in men of African ancestry. We use the heritability attributable to rare variants to estimate the coupling between selection and allelic effects at 0.48 (95% CI of [0.19, 0.78]) under the Eyre-Walker model. These results imply that natural selection has driven down the frequency of many prostate cancer risk alleles over evolutionary history. Overall our results show that a substantial fraction of the risk for prostate cancer in men of African ancestry lies in rare variants at known risk loci and suggests that rare variants make a significant contribution to heritability of common traits.