Polygenic risk score · London
A polygenic risk score is a signal, not a verdict.
PRS aggregates the effect of thousands to millions of common variants to estimate your cumulative genetic risk for polygenic diseases. Useful, emerging, and often oversold. Here is an honest read, and where it fits alongside standard risk assessment and monogenic testing.
In one paragraph
PRS meaningfully stratifies risk for coronary artery disease, several common cancers and T2DM in European populations. Performance drops in other ancestries. Clinical utility is emerging, not established. Best interpreted with a genetic counsellor and alongside standard risk tools.
What PRS covers
Conditions where a score is well-studied.
Distinct from monogenic testing (BRCA, Lynch, familial hypercholesterolaemia), which looks for a single high-penetrance variant. PRS captures the polygenic, common-variant contribution to disease risk.
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Coronary artery disease
Best-studied polygenic score. High-decile PRS confers 3-5x risk vs low-decile in European populations, comparable to a monogenic mutation in effect size.
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Type 2 diabetes
Cumulative common-variant risk that layers onto BMI, family history and lifestyle. Modestly improves prediction over QDiabetes alone.
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Breast cancer
BCAC 313-SNP score meaningfully stratifies risk in European women. Being explored alongside BRCA testing to refine screening age and modality.
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Prostate cancer
One of the strongest polygenic signals. High-PRS men have several-fold lifetime risk vs low-PRS men, informing PSA screening intensity.
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Colorectal cancer
Adds discrimination on top of family history and lifestyle factors. May inform colonoscopy start age in high-decile individuals.
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Atrial fibrillation & stroke
Emerging use as an adjunct to CHA2DS2-VASc and QRISK3 for cardiovascular risk stratification.
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Alzheimer's disease
PRS captures polygenic risk beyond APOE4. Clinical actionability is limited given the absence of disease-modifying therapy.
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Glaucoma & macular degeneration
Polygenic scores identify individuals who benefit from earlier or more frequent ophthalmology surveillance.
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IBD, obesity, mental health
Active research areas. Scores exist but clinical actionability outside research settings is limited today.
Evidence and limits
Interesting stratifier. Limited outcome evidence. Real equity issue.
The honest version, without the marketing gloss.
Where PRS earns its place
- High-decile individuals for CAD, breast, prostate carry risk comparable in magnitude to monogenic mutations.
- ESC and AHA cardiovascular guidelines increasingly acknowledge PRS as an adjunct alongside QRISK3, Framingham and ASCVD.
- Can inform screening intensification, statin thresholds and PSA cadence when the clinical picture is on the fence.
- NHS Our Future Health is evaluating PRS in a 5-million-adult study, the largest of its kind in the world.
Where PRS is oversold
- Discovery cohorts are overwhelmingly European. Performance drops substantially in South Asian, African and East Asian ancestries. This is a live equity problem.
- Few randomised trials show that PRS-guided care changes hard outcomes versus standard risk assessment.
- NICE has not endorsed routine PRS use for any indication.
- Results without counselling can cause distress, medicalisation, or false reassurance.
UK providers
Who actually does PRS in London.
A short, honest map of the private PRS market. We pair the lab with a genetic counsellor for interpretation.
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Genomics plc (Oxford)
UK spinout from the Big Data Institute. Integrated Risk Tool combines PRS with clinical risk factors for CAD, breast, prostate, T2DM.
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Allelica
Multi-disease PRS panel with clinical decision support. Widely used in US preventive cardiology, available privately in the UK.
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MyOme
Whole-genome PRS with monogenic reflex testing. Higher price point, comprehensive report.
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Nucleotide
London-based genomics service offering PRS alongside pharmacogenomics and carrier screening.
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Nordic Laboratories UK
Distributor for several European PRS panels, typically bundled with functional medicine workups.
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Randox Health
Consumer-facing PRS as part of broader biomarker packages. Less clinical depth than dedicated genomics providers.
Indicative pricing
Honest ranges across the London market.
Price depends on the provider, whether counselling is included, and whether monogenic reflex testing is bundled.
| Test | Indicative range | Sample | Report turnaround |
|---|---|---|---|
| Single-condition PRS (CAD, breast, prostate, T2DM) | £150-£350 | Saliva sample | 3-6 weeks |
| Multi-disease PRS panel (6-15 conditions) | £280-£650 | Saliva sample | 4-6 weeks |
| PRS with genetic counselling and interpretation report | £550-£1,400 | 2 x 45-60 min | 4-8 weeks |
| Combined PRS + monogenic panel (e.g. CAD PRS + FH genes) | £650-£1,600 | Saliva or blood | 4-8 weeks |
| Whole-genome sequencing with PRS derivation | £1,200-£2,800 | Blood sample | 6-10 weeks |
We do not recommend PRS testing without pre-test and post-test counselling. A raw risk decile with no clinical context is more likely to cause harm than change behaviour.
Related tests
What often pairs with, or replaces, PRS.
Depending on the question, a targeted monogenic panel or a structural cardiac test is often more actionable.
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Hereditary cancer panel (non-BRCA)
Monogenic panel testing for Lynch, TP53, PALB2 and other high-penetrance cancer syndromes.
Read more -
BRCA genetic test
Focused BRCA1 and BRCA2 analysis, with counselling.
Read more -
Whole genome sequencing
Comprehensive genome analysis, monogenic and polygenic in one report.
Read more -
Whole exome sequencing
Coding-region sequencing for suspected monogenic disease.
Read more -
Pharmacogenomic testing
Drug metabolism genotyping (CYP2D6, CYP2C19, DPYD, TPMT).
Read more -
Coronary CT angiography
Direct visualisation of coronary plaque, complements a high CAD PRS.
Read more -
CT coronary calcium score
Actionable structural cardiac risk marker, often paired with PRS.
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Longevity biomarker clinic
PRS integrated with imaging, bloods and lifestyle assessment.
Read more
Frequently asked
What patients ask before booking.
Straight answers on accuracy, ancestry, insurance, actionability and NHS availability.
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How accurate is a polygenic risk score?
PRS is a stratifier, not a diagnostic test. For well-studied conditions like coronary artery disease and prostate cancer, being in the top PRS decile confers roughly 3 to 5 times the risk of the bottom decile in European populations. That is a meaningful signal, but it does not predict whether you will develop the disease. Standard clinical risk tools (QRISK3, Framingham, QDiabetes) still do most of the work, and PRS adds incremental discrimination on top.
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Does PRS work equally well across ethnic groups?
No, and this is the single most important limitation. Almost all discovery cohorts have been of European ancestry, so scores perform significantly less well in South Asian, African and East Asian populations. Predictive accuracy can drop by half or more. Multi-ancestry PRS methods are being developed and the NHS Our Future Health study is recruiting 5 million UK adults partly to address this gap, but until that work matures a PRS result in a non-European individual should be interpreted with real caution.
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Will a PRS result affect my life insurance?
Under the ABI Code on Genetic Testing (Concordat and Moratorium, 2018 update), UK insurers cannot ask you to disclose predictive genetic test results, including PRS, for life cover up to £500,000 or critical illness cover up to £300,000. Above those thresholds the position is more nuanced and only Huntington's disease results must be disclosed on request. We recommend reviewing the current ABI position with an independent adviser before testing.
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Is a PRS actionable?
Sometimes. A high CAD PRS may justify earlier statin discussion, a coronary calcium score, or tighter blood pressure targets. A high prostate cancer PRS may support earlier or more frequent PSA testing. A high breast cancer PRS can inform screening start age and modality. However, few randomised trials have yet demonstrated that PRS-guided care improves hard outcomes versus standard risk assessment. NICE has not endorsed routine PRS use. Treat it as a decision-support signal that your clinician weighs alongside family history, bloods and lifestyle.
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How is PRS different from BRCA or Lynch testing?
Monogenic tests like BRCA1, BRCA2 and Lynch syndrome look for rare, high-penetrance variants in a single gene. If you carry one, your lifetime cancer risk is substantially elevated and management guidelines are clear. PRS aggregates the small effects of thousands to millions of common variants across the genome to estimate cumulative polygenic risk. The two are complementary. Where family history suggests a monogenic syndrome, targeted panel testing comes first.
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Is PRS available on the NHS?
Not routinely. The NHS Genomic Medicine Service currently offers monogenic testing through defined care pathways but does not commission PRS for common disease risk. The Our Future Health study is generating PRS data at population scale for research and may return results to participants in future. For now, clinical PRS in the UK is a private service, and should only be undertaken with proper counselling before and after the test.
Speak to us before you order
A PRS report without context is worse than no report at all.
We match you to the right provider, add a genetic counsellor for pre-test and post-test consultation, and integrate the result with your standard risk assessment and any monogenic testing that is indicated. Free concierge, reply within one working day.
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