Glucosamine Use and Risk of Colorectal Cancer: Results from UK Biobank

ObjectiveTo systematically identify and validate published colorectal cancer risk prediction models that do not require invasive testing in two large population-based prospective cohorts.DesignModels were identified through an update of a published systematic review and validated in the European Prospective Investigation into Cancer and Nutrition (EPIC) and the UK Biobank. The performance of the models to predict the occurrence of colorectal cancer within 5 or 10 years after study enrolment was assessed by discrimination (C-statistic) and calibration (plots of observed vs predicted probability).ResultsThe systematic review and its update identified 16 models from 8 publications (8 colorectal, 5 colon and 3 rectal). The number of participants included in each model validation ranged from 41 587 to 396 515, and the number of cases ranged from 115 to 1781. Eligible and ineligible participants across the models were largely comparable. Calibration of the models, where assessable, was very good and further improved by recalibration. The C-statistics of the models were largely similar between validation cohorts with the highest values achieved being 0.70 (95% CI 0.68 to 0.72) in the UK Biobank and 0.71 (95% CI 0.67 to 0.74) in EPIC.ConclusionSeveral of these non-invasive models exhibited good calibration and discrimination within both external validation populations and are therefore potentially suitable candidates for the facilitation of risk stratification in population-based colorectal screening programmes. Future work should both evaluate this potential, through modelling and impact studies, and ascertain if further enhancement in their performance can be obtained.

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Explaining the link between adiposity and colorectal cancer risk in men and postmenopausal women in the UK Biobank: A sequential causal mediation analysis

International Journal of Cancer ◽

10.1002/ijc.32980 ◽

2020 ◽

Vol 147 (7) ◽

pp. 1881-1894 ◽

Cited By ~ 2

Author(s):

S. Ghazaleh Dashti ◽

Vivian Viallon ◽

Julie A. Simpson ◽

Amalia Karahalios ◽

Margarita Moreno‐Betancur ◽

...

Keyword(s):

Colorectal Cancer ◽

Cancer Risk ◽

Postmenopausal Women ◽

Mediation Analysis ◽

Colorectal Cancer Risk ◽

Uk Biobank ◽

Causal Mediation ◽

Causal Mediation Analysis ◽

The Uk

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External validation of risk prediction models for incident colorectal cancer using UK Biobank

British Journal of Cancer ◽

10.1038/bjc.2017.463 ◽

2018 ◽

Vol 118 (5) ◽

pp. 750-759 ◽

Cited By ~ 15

Author(s):

J A Usher-Smith ◽

A Harshfield ◽

C L Saunders ◽

S J Sharp ◽

J Emery ◽

...

Keyword(s):

Colorectal Cancer ◽

Prediction Models ◽

Characteristic Curve ◽

External Validation ◽

Risk Scores ◽

Prior History ◽

Uk Biobank ◽

Risk Models ◽

Potential Health ◽

Men And Women

Abstract Background: This study aimed to compare and externally validate risk scores developed to predict incident colorectal cancer (CRC) that include variables routinely available or easily obtainable via self-completed questionnaire. Methods: External validation of fourteen risk models from a previous systematic review in 373 112 men and women within the UK Biobank cohort with 5-year follow-up, no prior history of CRC and data for incidence of CRC through linkage to national cancer registries. Results: There were 1719 (0.46%) cases of incident CRC. The performance of the risk models varied substantially. In men, the QCancer10 model and models by Tao, Driver and Ma all had an area under the receiver operating characteristic curve (AUC) between 0.67 and 0.70. Discrimination was lower in women: the QCancer10, Wells, Tao, Guesmi and Ma models were the best performing with AUCs between 0.63 and 0.66. Assessment of calibration was possible for six models in men and women. All would require country-specific recalibration if estimates of absolute risks were to be given to individuals. Conclusions: Several risk models based on easily obtainable data have relatively good discrimination in a UK population. Modelling studies are now required to estimate the potential health benefits and cost-effectiveness of implementing stratified risk-based CRC screening.

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Meat intake and cancer risk: prospective analyses in UK Biobank

10.1101/19003822 ◽

2019 ◽

Cited By ~ 1

Author(s):

Anika Knuppel ◽

Keren Papier ◽

Georgina K. Fensom ◽

Paul N. Appleby ◽

Julie A. Schmidt ◽

...

Keyword(s):

Prostate Cancer ◽

Colorectal Cancer ◽

Cancer Risk ◽

Meat Consumption ◽

Red Meat ◽

Processed Meat ◽

Uk Biobank ◽

Meat Intake ◽

Incidence Trends ◽

Red And Processed Meat

AbstractBackgroundRed and processed meat has been consistently associated with risk for colorectal cancer, but evidence for other cancer sites is limited and few studies have examined the association between poultry intake and cancer risk. We examined associations between total meat, red meat, processed meat and poultry intake and incidence for 20 common cancer sites.Methods and FindingsWe analysed data from 475,023 participants (54% women) in UK Biobank. Participants were aged 37-73 years and cancer free at baseline. Information on meat consumption was based on a touchscreen questionnaire completed at baseline covering type and frequency of meat intake. Diet intake was re-measured a minimum of three times in a subsample (15%) using a web-based 24h dietary recall questionnaire. Multivariable-adjusted Cox proportional hazards models were used to determine the association between baseline meat intake and cancer incidence. Trends in risk across baseline meat intake categories were calculated by assigning a mean value to each category using estimates from the re-measured meat intakes. During a mean follow-up of 6.9 years, 28,955 participants were diagnosed with a malignant cancer. Total, red and processed meat intakes were each positively associated with risk of colorectal cancer (e.g. hazard ratio (HR) per 70 g/day higher intake of red and processed meat combined 1.31, 95%-confidence interval (CI) 1.14-1.52).Red meat intake was positively associated with breast cancer (HR per 50 g/day higher intake 1.12, 1.01-1.24) and prostate cancer (1.15, 1.03-1.29). Poultry intake was positively associated with risk for cancers of the lymphatic and hematopoietic tissues (HR per 30g/day higher intake 1.16, 1.03-1.32). Only the associations with colorectal cancer were robust to Bonferroni correction for multiple comparisons. Study limitations include unrepresentativeness of the study sample for the UK population, low case numbers for less common cancers and the possibility of residual confounding.ConclusionsHigher intakes of red and processed meat were associated with a higher risk of colorectal cancer. The observed positive associations of red meat consumption with breast and prostate cancer, and poultry intake with cancers of the lymphatic and hematopoietic tissues, require further investigation.

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The added value of genetic information in colorectal cancer risk prediction models: development and evaluation in the UK Biobank prospective cohort study

British Journal of Cancer ◽

10.1038/s41416-018-0282-8 ◽

2018 ◽

Vol 119 (8) ◽

pp. 1036-1039 ◽

Cited By ~ 11

Author(s):

Todd Smith ◽

Marc J. Gunter ◽

Ioanna Tzoulaki ◽

David C. Muller

Keyword(s):

Colorectal Cancer ◽

Cohort Study ◽

Cancer Risk ◽

Genetic Information ◽

Prospective Cohort ◽

Prediction Models ◽

Added Value ◽

Uk Biobank ◽

Risk Prediction Models ◽

The Uk

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Risk of cancer in regular and low meat-eaters, fish-eaters, and vegetarians: a prospective analysis of UK Biobank participants

10.1101/2021.09.15.21263656 ◽

2021 ◽

Author(s):

Cody Z. Watling ◽

Julie A. Schmidt ◽

Yashvee Dunneram ◽

Tammy Y. N. Tong ◽

Rebecca K. Kelly ◽

...

Keyword(s):

Breast Cancer ◽

Prostate Cancer ◽

Colorectal Cancer ◽

Lower Risk ◽

Prostate Cancer Risk ◽

Postmenopausal Breast Cancer ◽

Prospective Analysis ◽

Inverse Association ◽

Uk Biobank ◽

Risk Of Cancer

Background: Following a vegetarian diet has become increasingly popular and some evidence suggests that being vegetarian may be associated with a lower risk of cancer overall. However, for specific cancer sites, the evidence is limited. Aim: To assess the associations of vegetarian and non-vegetarian diets with risks of all cancer, colorectal cancer, postmenopausal breast cancer, and prostate cancer, and to explore the role of potential mediators between these associations. Methods: We conducted a prospective analysis of 472,377 UK Biobank participants who were free from cancer at recruitment. Participants were categorised into regular meat-eaters (n=247,571), low meat-eaters (n=205,385), fish-eaters (n=10,696), and vegetarians (n=8,685) based on dietary questions completed at recruitment. Multivariable-adjusted Cox regressions were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for all cancer incidence and separate cancer sites across diet groups. Results: After an average follow-up of 11.4 years, 54,961 incident cancers were identified, including 5,882 colorectal, 7,537 postmenopausal breast, 9,501 prostate cancer cases. Compared with regular meat-eaters, being a low meat-eater, fish-eater, or vegetarian were all associated with a lower risk of all cancer (HR: 0.98, 95% CI: 0.96-1.00; 0.90, 0.84-0.96; 0.86, 0.80-0.93, respectively). Being a low meat-eater was associated with a lower risk of colorectal cancer in comparison to regular meat-eaters (0.91, 0.86-0.96); there was heterogeneity in this association by sex (p=0.007), with an inverse association across diet groups in men, but not in women. Vegetarian postmenopausal women had a lower risk of breast cancer (0.82, 0.68-0.99), which was attenuated and non-significant after adjusting for body mass index (BMI; 0.87, 0.72-1.05); in mediation analyses, BMI was found to possibly mediate the observed association. In men, being a fish-eater or a vegetarian was inversely associated with prostate cancer risk (0.80, 0.65-0.99 and 0.69, 0.54-0.89, respectively). Conclusion: Low and non-meat-eaters had a lower risk of being diagnosed with cancer in comparison to regular meat-eaters. We also found that low meat-eaters had a lower risk of colorectal cancer, vegetarian women had a lower risk of postmenopausal breast cancer, and vegetarians and fish-eaters had a lower risk of being diagnosed with prostate cancer. The lower risk of colorectal cancer in low meat-eaters is consistent with previous evidence suggesting an adverse impact of meat intake. The lower risk of postmenopausal breast cancer in vegetarian women may be explained by their lower BMI. It is not clear whether the other differences observed, for all cancers and for prostate cancer, reflect any causal relationships or are or due to other factors such as residual confounding or differences in cancer detection.

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