Colorectal Cancer Risk Prediction Tool for White Men and Women Without Known Susceptibility

Purpose Given the high incidence of colorectal cancer (CRC), and the availability of procedures that can detect disease and remove precancerous lesions, there is a need for a model that estimates the probability of developing CRC across various age intervals and risk factor profiles. Methods The development of separate CRC absolute risk models for men and women included estimating relative risks and attributable risk parameters from population-based case-control data separately for proximal, distal, and rectal cancer and combining these estimates with baseline age-specific cancer hazard rates based on Surveillance, Epidemiology, and End Results (SEER) incidence rates and competing mortality risks. Results For men, the model included a cancer-negative sigmoidoscopy/colonoscopy in the last 10 years, polyp history in the last 10 years, history of CRC in first-degree relatives, aspirin and nonsteroidal anti-inflammatory drug (NSAID) use, cigarette smoking, body mass index (BMI), current leisure-time vigorous activity, and vegetable consumption. For women, the model included sigmoidoscopy/colonoscopy, polyp history, history of CRC in first-degree relatives, aspirin and NSAID use, BMI, leisure-time vigorous activity, vegetable consumption, hormone-replacement therapy (HRT), and estrogen exposure on the basis of menopausal status. For men and women, relative risks differed slightly by tumor site. A validation study in independent data indicates that the models for men and women are well calibrated. Conclusion We developed absolute risk prediction models for CRC from population-based data, and a simple questionnaire suitable for self-administration. This model is potentially useful for counseling, for designing research intervention studies, and for other applications.

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Colorectal cancer risk prediction tool for men and women without known susceptibility

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e15002 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e15002-e15002

Author(s):

A. N. Freedman ◽

M. L. Slattery ◽

R. Ballard-Barbash ◽

G. Willis ◽

B. J. Cann ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Prediction ◽

Leisure Time ◽

Vegetable Consumption ◽

Absolute Risk ◽

Population Based ◽

Vigorous Activity ◽

Men And Women ◽

Relative Risks ◽

History Of

e15002 Background: Given the high incidence of colorectal cancer (CRC), and the availability of procedures that can detect disease and remove precancerous lesions, there is a need for a model that estimates the probability of developing CRC across various age intervals and risk factor profiles. Methods: The development of separate CRC absolute risk models for men and women included estimating relative risks and attributable risk parameters from population-based case-control data separately for proximal, distal, and rectal cancer and combining these estimates with baseline age-specific cancer hazard rates based on Surveillance, Epidemiology, and End Results (SEER) incidence rates and competing mortality risks. Results: For men, the model included a cancer- negative sigmoidoscopy/colonoscopy in the last 10 years, polyp history in the last 10 years, history of CRC in first-degree relatives, aspirin and nonsteroidal anti-inflammatory drug (NSAID) use, cigarette smoking, body mass index (BMI), current leisure-time vigorous activity, and vegetable consumption. For women, the model included sigmoidoscopy/colonoscopy, polyp history, history of CRC in first-degree relatives, aspirin and NSAID use, BMI, leisure-time vigorous activity, vegetable consumption, hormone-replacement therapy (HRT), and estrogen exposure on the basis of menopausal status. For men and women, relative risks differed slightly by tumor site. A validation study in independent data indicates that the models for men and women are well calibrated. Conclusions: We developed absolute risk prediction models for CRC from population-based data, and a simple questionnaire suitable for self-administration. This model is potentially useful for counseling, for designing research intervention studies, and for other applications. No significant financial relationships to disclose.

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Association of use of bisphosphonates with risk of colorectal cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.4_suppl.371 ◽

2011 ◽

Vol 29 (4_suppl) ◽

pp. 371-371

Author(s):

G. Rennert ◽

M. Pinchev ◽

H. S. Rennert ◽

S. B. Gruber

Keyword(s):

Breast Cancer ◽

Colorectal Cancer ◽

Vegetable Consumption ◽

Population Based ◽

Relative Reduction ◽

Sports Activity ◽

Low Dose Aspirin ◽

History Of ◽

Post Menopausal ◽

One Year

371 Background: Bisphosphonates are commonly used for the treatment of osteoporosis and of bone metastases due to breast cancer and were recently reported to be associated with reduced risk of breast cancer, but their association with risk of other cancers is unknown. Methods: The Molecular Epidemiology of Colorectal Cancer (MECC) study is a population-based case-control study in northern Israel of colorectal cancer cases and age/sex/clinic/ethnic-group matched controls. Use of bisphosphonates prior to diagnosis was assessed in a subset of 933 pairs of post-menopausal female cases and controls, enrolled in Clalit Health Services (CHS), using computerized pharmacy records. Results: The use of bisphosphonates for more than one year prior to diagnosis, but not for less than a year, was associated with a significantly reduced relative risk of colorectal cancer (odds ratio=0.50, 95% CI: 0.35-0.71). This association remained statistically significant after adjustment for, vegetable consumption, sports activity, family history of colorectal cancer, , BMI, use of low-dose aspirin, statins, vitamin D and post-menopausal hormones (OR=0.40, 0.24-0.64). Concomitant use of bisphosphonates and statins did not further reduce the risk. Conclusions: The use of oral bisphosphonates for more than 1 year was associated with a 60% relative reduction in the risk of colorectal cancer similar to the recently reported association of this drug class with reduction in breast cancer risk. No significant financial relationships to disclose.

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Use of Bisphosphonates and Reduced Risk of Colorectal Cancer

Journal of Clinical Oncology ◽

10.1200/jco.2010.33.7485 ◽

2011 ◽

Vol 29 (9) ◽

pp. 1146-1150 ◽

Cited By ~ 70

Author(s):

Gad Rennert ◽

Mila Pinchev ◽

Hedy S. Rennert ◽

Stephen B. Gruber

Keyword(s):

Breast Cancer ◽

Colorectal Cancer ◽

Mevalonate Pathway ◽

Vegetable Consumption ◽

Population Based ◽

Relative Reduction ◽

Sports Activity ◽

Low Dose Aspirin ◽

History Of ◽

Reduced Risk

Purpose Bisphosphonates are commonly used for the treatment of osteoporosis and bone metastases caused by breast cancer and were recently reported to be associated with a reduced risk of breast cancer, possibly acting through the mevalonate pathway, but their association with risk of other cancers is unknown. Patients and Methods The Molecular Epidemiology of Colorectal Cancer study is a population-based, case-control study in northern Israel of patients with colorectal cancer and age-, sex-, clinic-, and ethnic group–matched controls. Long-term use of bisphosphonates before diagnosis was assessed in a subset of 933 pairs of postmenopausal female patients and controls, enrolled in Clalit Health Services, using computerized pharmacy records. Results The use of bisphosphonates for more than 1 year before diagnosis, but not for less than 1 year, was associated with a significantly reduced relative risk (RR) of colorectal cancer (RR, 0.50; 95% CI, 0.35 to 0.71). This association remained statistically significant after adjustment in a model for vegetable consumption, sports activity, family history of colorectal cancer, body mass index, and use of low-dose aspirin, statins, vitamin D, and postmenopausal hormones (RR, 0.41; 95% CI, 0.25 to 0.67). Concomitant use of bisphosphonates and statins did not further reduce the risk. Conclusion The use of oral bisphosphonates for more than 1 year was associated with a 59% relative reduction in the risk of colorectal cancer, similar to the recently reported association of this drug class with reduction in breast cancer risk.

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Validation of a Colorectal Cancer Risk Prediction Model Among White Patients Age 50 Years and Older

Journal of Clinical Oncology ◽

10.1200/jco.2008.17.4813 ◽

2009 ◽

Vol 27 (5) ◽

pp. 694-698 ◽

Cited By ~ 86

Author(s):

Yikyung Park ◽

Andrew Nathan Freedman ◽

Mitchell H. Gail ◽

David Pee ◽

Albert Hollenbeck ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Factor ◽

Cohort Study ◽

Prediction Model ◽

Risk Prediction ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Absolute Risk ◽

Risk Prediction Model ◽

Men And Women

Purpose Validation of an absolute risk prediction model for colorectal cancer (CRC) by using a large, population-based cohort. Patients and Methods The National Institutes of Health (NIH) –American Association of Retired Persons (AARP) diet and health study, a prospective cohort study, was used to validate the model. Men and women age 50 to 71 years at baseline answered self-administered questionnaires that asked about demographic characteristics, diet, lifestyle, and medical histories. We compared expected numbers of CRC patient cases predicted by the model to the observed numbers of CRC patient cases identified in the NIH-AARP study overall and in subgroups defined by risk factor combinations. The discriminatory power was measured by the area under the receiver-operating characteristic curve (AUC). Results During an average of 6.9 years of follow-up, we identified 2,092 and 832 incident CRC patient cases in men and women, respectively. The overall expected/observed ratio was 0.99 (95% CI, 0.95 to 1.04) in men and 1.05 (95% CI, 0.98 to 1.11) in women. Agreement between the expected and the observed number of cases was good in most risk factor categories, except for in subgroups defined by CRC screening and polyp history. This discrepancy may be caused by differences in the question on screening and polyp history between two studies. The AUC was 0.61 (95% CI, 0.60 to 0.62) for men and 0.61 (95% CI, 0.59 to 0.62) for women, which was similar to other risk prediction models. Conclusion The absolute risk model for CRC was well calibrated in a large prospective cohort study. This prediction model, which estimates an individual's risk of CRC given age and risk factors, may be a useful tool for physicians, researchers, and policy makers.

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A microRNA panel compared to environmental and polygenic scores for colorectal cancer risk prediction

Nature Communications ◽

10.1038/s41467-021-25067-8 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Janhavi R. Raut ◽

Ben Schöttker ◽

Bernd Holleczek ◽

Feng Guo ◽

Megha Bhardwaj ◽

...

Keyword(s):

Colorectal Cancer ◽

Risk Prediction ◽

Risk Score ◽

Characteristic Curve ◽

Predictive Ability ◽

Population Based ◽

Polygenic Risk Score ◽

Nucleotide Polymorphisms ◽

Polygenic Scores

AbstractCirculating microRNAs (miRNAs) could improve colorectal cancer (CRC) risk prediction. Here, we derive a blood-based miRNA panel and evaluate its ability to predict CRC occurrence in a population-based cohort of adults aged 50–75 years. Forty-one miRNAs are preselected from independent studies and measured by quantitative-real-time-polymerase-chain-reaction in serum collected at baseline of 198 participants who develop CRC during 14 years of follow-up and 178 randomly selected controls. A 7-miRNA score is derived by logistic regression. Its predictive ability, quantified by the optimism-corrected area-under-the-receiver-operating-characteristic-curve (AUC) using .632+ bootstrap is 0.794. Predictive ability is compared to that of an environmental risk score (ERS) based on known risk factors and a polygenic risk score (PRS) based on 140 previously identified single-nucleotide-polymorphisms. In participants with all scores available, optimism-corrected-AUC is 0.802 for the 7-miRNA score, while AUC (95% CI) is 0.557 (0.498–0.616) for the ERS and 0.622 (0.564–0.681) for the PRS.

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Incidence of severe knee and hip osteoarthritis in relation to different measures of body mass: a population-based prospective cohort study

Annals of the Rheumatic Diseases ◽

10.1136/ard.2008.089748 ◽

2008 ◽

Vol 68 (4) ◽

pp. 490-496 ◽

Cited By ~ 201

Author(s):

L S Lohmander ◽

M Gerhardsson de Verdier ◽

J Rollof ◽

P M Nilsson ◽

G Engström

Keyword(s):

Cohort Study ◽

Waist Circumference ◽

Knee Osteoarthritis ◽

Body Mass ◽

Hip Osteoarthritis ◽

Population Based ◽

Normal Weight ◽

Men And Women ◽

Relative Risks ◽

Percentage Of Body Fat

Objective:To determine in a prospective population-based cohort study relationships between different measures of body mass and the incidence of severe knee and hip osteoarthritis defined as arthroplasty of knee or hip due to osteoarthritis.Materials and methods:Body mass index (BMI), waist circumference, waist–hip ratio (WHR), weight and percentage of body fat (BF%) were measured at baseline in 11 026 men and 16 934 women from the general population. The incidence of osteoarthritis over 11 years was monitored by linkage with the Swedish hospital discharge register.Results:471 individuals had knee osteoarthritis and 551 had hip osteoarthritis. After adjustment for age, sex, smoking and physical activity, the relative risks (RR) of knee osteoarthritis (fourth vs first quartile) were 8.1 (95% CI 5.3 to 12.4) for BMI, 6.7 (4.5 to 9.9) for waist circumference, 6.5 (4.6 to 9.43) for weight, 3.6 (2.6 to 5.0) for BF% and 2.2 (1.7 to 3.0) for WHR. Corresponding RR for hip osteoarthritis were 2.6 (2.0 to 3.4) for BMI, 3.0 (2.3 to 4.0) for weight, 2.5 (1.9 to 3.3) for waist, 1.3 (0.99 to 1.6) for WHR and 1.5 (1.2 to 2.0) for BF%.Conclusion:All measures of overweight were associated with the incidence of knee osteoarthritis, with the strongest relative risk gradient observed for BMI. The incidence of hip osteoarthritis showed smaller but significant differences between normal weight and obesity. Our results support a major link between overweight and biomechanics in increasing the risk of knee and hip osteoarthritis in men and women.

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Abstract P355: Predicting the 20-year Risk of First Coronary or Ischemic Stroke Event in Northern Italy: The CAMUNI Absolute Risk Equation

Circulation ◽

10.1161/circ.127.suppl_12.ap355 ◽

2013 ◽

Vol 127 (suppl_12) ◽

Author(s):

Giovanni Veronesi ◽

Lloyd E Chambless ◽

Francesco Gianfagna ◽

Giuseppe Mancia ◽

Giancarlo Cesana ◽

...

Keyword(s):

Blood Pressure ◽

Family History ◽

Diastolic Blood Pressure ◽

Cardiovascular Events ◽

Absolute Risk ◽

Northern Italy ◽

Men And Women ◽

Basic Model ◽

History Of

Aims. Recent US guidelines advocate the introduction of lifetime or long-term absolute risk prediction for primary prevention of cardiovascular events, especially for young people and women. Therefore, long-term prediction models might be specially beneficial in population considered at low incidence. We aim to develop a 20-year absolute risk prediction equation in a Northern Italy population. Methods. Four independent population-based cohorts were enrolled between 1986 and 1994 from the Brianza population (Northern Italy), adopting standardized MONICA procedures. The study sample comprises n=2574 men and 2673 women, aged 35 to 69 years and free of CVD at baseline. Participants were followed-up for incidence of first coronary and ischemic stroke events (fatal and non-fatal; all MONICA validated) for a median time of 15 years (IQ range: 12-20) and up to the end of 2008. We compared several gender-specific Cox Proportional Hazards models: the basic one includes age, total cholesterol, HDL-cholesterol, systolic blood pressure, anti-hypertensive treatment, cigarette smoking and diabetes. Candidates to model addition were diastolic blood pressure, triglycerides, BMI, family history of CHD, and education. Model calibration was tested using the Grønnesby-Bogan goodness-of-fit statistic. The Area Under the ROC-Curve (AUC) was a measure of discrimination, corrected for over-optimism via bootstrapping. Changes in discrimination (Δ-AUC) and reclassification (Net Reclassification Improvement, NRI) defined the improvement from the basic model due to an additional risk factor. Intermediate risk was defined as 20-year risk between 10% and 40%. Results. We observed n=286 events in men (incidence rate 7.7 per 1000 person-years) and n=108 in women (2.6 per 1000 person-years). All risk factors included in the basic model were predictive of first cardiovascular event in both genders; discrimination was 0.725 and 0.802 in men and women, respectively. Average specificity in the top risk quintile (cut-off value: 23% in men and 8.5% in women) was similar in men and women (85% vs. 83%), while sensitivity was higher in women (63% vs. 46%). All the models were well-calibrated (p-values >0.05). The addition of a positive family history of CHD in men (Hazard Ratio: 1.6; 95%CI 1.2-2.1) and of diastolic blood pressure in women (HR: 1.4 for 11 mmHg increase; 1.1-1.8) significantly improved discrimination (Δ-AUC=0.01; 95%CI 0.002-0.02 [men] and Δ-AUC=0.005; 95%CI 0.0001-0.01 [women]) and reclassification of subjects at intermediate risk (NRI=8.4%;1.7%-19.1% [men]; and NRI=11.7%; -3.2%-33.5% [women]). Conclusions. Traditional risk factors are predictive of cardiovascular events after 20 years, with good discrimination. The addition of family history of CHD may contribute to model improvement, at least among men; the role of diastolic blood pressure in women should be carefully evaluated.

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Familial Aggregation of Psoriasis and Co-Aggregation of Autoimmune Diseases in Affected Families

Journal of Clinical Medicine ◽

10.3390/jcm8010115 ◽

2019 ◽

Vol 8 (1) ◽

pp. 115 ◽

Cited By ~ 5

Author(s):

Yu-Huei Huang ◽

Chang-Fu Kuo ◽

Lu-Hsiang Huang ◽

Mei-Yun Hsieh

Keyword(s):

Autoimmune Diseases ◽

Genetic Factors ◽

Familial Aggregation ◽

Population Based ◽

Study Cohort ◽

Genetic Contribution ◽

Degree Relative ◽

Nationwide Study ◽

Relative Risks ◽

History Of

Psoriasis is considered to result from the interaction of genetic factors and environmental exposure. The evidence for familial aggregation in psoriasis has been reported but population-based studies related to the magnitude of genetic contribution to psoriasis are rare. This study aimed to evaluate the relative risks of psoriasis in individuals with affected relatives and to calculate the proportion of genetic, shared, and non-shared environmental factors contributing to psoriasis. The study cohort included 69,828 patients diagnosed with psoriasis enrolled in National health Insurance in 2010. The adjusted relative risks (RR) for individuals with an affected first-degree relative and affected second-degree relative were 5.50 (95% CI (Confidence Interval), 5.19–5.82) and 2.54 (95% CI, 2.08–3.12) respectively. For those who have affected first-degree relatives, their RR was 1.45 (95% CI, 1.17–1.79) for Sjogren’s syndrome and 1.94 (95% CI, 1.15–3.27) for systemic sclerosis. This nationwide study ascertains that family history of psoriasis is a risk factor for psoriasis. Individuals with relatives affected by psoriasis have higher risks of developing some autoimmune diseases.

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Associations of Leisure-Time Physical Activity with Mobility Difficulties among Middle-Aged and Older Adults

Journal of Aging and Physical Activity ◽

10.1123/japa.14.2.133 ◽

2006 ◽

Vol 14 (2) ◽

pp. 133-153 ◽

Cited By ~ 6

Author(s):

Jarmo J. Malmberg ◽

Seppo I. Miilunpalo ◽

Matti E. Pasanen ◽

Ilkka M. Vuori ◽

Pekka Oja

Keyword(s):

Physical Activity ◽

Older Adults ◽

Leisure Time ◽

Leisure Time Physical Activity ◽

Population Based ◽

Stair Climbing ◽

Middle Aged ◽

Men And Women ◽

Future Risk

The authors investigated the associations of the amount, frequency and intensity, and type of leisure-time physical activity (LTPA) with the risk of self-reported difficulty in walking (WD) and stair climbing (SCD) over 16 years in a population-based cohort age 40–64 years at the onset of the study. Their results indicated that the risk for SCD was highest among men and women with a low amount of weekly LTPA. The risk was high also among women with weekly light LTPA compared with women with weekly vigorous LTPA. The risk for WD was highest among men who engaged in fitness activity once a week compared with men who engaged in fitness activity at least three times a week. A low amount of weekly LTPA, light LTPA twice or more a week, and LTPA for keeping fit and healthy less than three times a week are associated with future risk of mobility difficulties among middle-aged and older adults.

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