Negative selection on complex traits limits genetic risk prediction accuracy between populations

Abstract Accurate genetic risk prediction is a key goal for medical genetics and great progress has been made toward identifying individuals with extreme risk across several traits and diseases (Collins and Varmus, 2015). However, many of these studies are done in predominantly European populations (Bustamante et al., 2011; Popejoy and Fullerton, 2016). Although GWAS effect sizes correlate across ancestries (Wojcik et al., 2019), risk scores show substantial reductions in accuracy when applied to non-European populations (Kim et al., 2018; Martin et al., 2019; Scutari et al., 2016). We use simulations to show that human demographic history and negative selection on complex traits result in population specific genetic architectures. For traits under moderate negative selection, ~50% of the heritability can be accounted for by variants in Europe that are absent from Africa. We show that this directly leads to poor performance in risk prediction when using variants discovered in Europe to predict risk in African populations, especially in the tails of the risk distribution. To evaluate the impact of this effect in genomic data, we built a Bayesian model to stratify heritability between European-specific and shared variants and applied it to 43 traits and diseases in the UK Biobank. Across these phenotypes, we find ~50% of the heritability comes from European-specific variants, setting an upper bound on the accuracy of genetic risk prediction in non-European populations using effect sizes discovered in European populations. We conclude that genetic association studies need to include more diverse populations to enable to utility of genetic risk prediction in all populations.