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  • Aleksandrova, KrasimiraLeibniz Institute for Prevention Research and Epidemiology - BIPS GmbH,German Institute of Human Nutrition,University of Potsdam (author)

Development and validation of a lifestyle-based model for colorectal cancer risk prediction : the LiFeCRC score

  • Article/chapterEnglish2021

Publisher, publication year, extent ...

  • 2021-01-04
  • Springer Science and Business Media LLC,2021

Numbers

  • LIBRIS-ID:oai:lup.lub.lu.se:c74fe4ee-ccb6-4073-98cd-6ec6e0579091
  • https://lup.lub.lu.se/record/c74fe4ee-ccb6-4073-98cd-6ec6e0579091URI
  • https://doi.org/10.1186/s12916-020-01826-0DOI
  • https://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-178982URI

Supplementary language notes

  • Language:English
  • Summary in:English

Part of subdatabase

Classification

  • Subject category:art swepub-publicationtype
  • Subject category:ref swepub-contenttype

Notes

  • Background: Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate behaviour change. We therefore developed and validated a lifestyle-based CRC risk prediction algorithm in an asymptomatic European population. Methods: The model was based on data from 255,482 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study aged 19 to 70 years who were free of cancer at study baseline (1992–2000) and were followed up to 31 September 2010. The model was validated in a sample comprising 74,403 participants selected among five EPIC centres. Over a median follow-up time of 15 years, there were 3645 and 981 colorectal cancer cases in the derivation and validation samples, respectively. Variable selection algorithms in Cox proportional hazard regression and random survival forest (RSF) were used to identify the best predictors among plausible predictor variables. Measures of discrimination and calibration were calculated in derivation and validation samples. To facilitate model communication, a nomogram and a web-based application were developed. Results: The final selection model included age, waist circumference, height, smoking, alcohol consumption, physical activity, vegetables, dairy products, processed meat, and sugar and confectionary. The risk score demonstrated good discrimination overall and in sex-specific models. Harrell’s C-index was 0.710 in the derivation cohort and 0.714 in the validation cohort. The model was well calibrated and showed strong agreement between predicted and observed risk. Random survival forest analysis suggested high model robustness. Beyond age, lifestyle data led to improved model performance overall (continuous net reclassification improvement = 0.307 (95% CI 0.264–0.352)), and especially for young individuals below 45 years (continuous net reclassification improvement = 0.364 (95% CI 0.084–0.575)). Conclusions: LiFeCRC score based on age and lifestyle data accurately identifies individuals at risk for incident colorectal cancer in European populations and could contribute to improved prevention through motivating lifestyle change at an individual level.

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  • Reichmann, RobinUniversity of Potsdam,German Institute of Human Nutrition (author)
  • Kaaks, RudolfGerman Cancer Research Centre (author)
  • Jenab, MazdaInternational Agency for Research on Cancer, World Health Organization,Imperial College London (author)
  • Bueno-de-Mesquita, H. BasNational Institute for Public Health and the Environment (RIVM),Imperial College London (author)
  • Dahm, Christina C.Aarhus University (author)
  • Eriksen, Anne KirstineDanish Cancer Society (author)
  • Tjønneland, AnneDanish Cancer Society (author)
  • Artaud, FannyInstitut Gustave Roussy,University of Paris-Saclay (author)
  • Boutron-Ruault, Marie ChristineInstitut Gustave Roussy,University of Paris-Saclay (author)
  • Severi, GianlucaInstitut Gustave Roussy,University of Paris-Saclay,University of Florence (author)
  • Hüsing, AnikaGerman Cancer Research Centre (author)
  • Trichopoulou, AntoniaHellenic Health Foundation, Athens (author)
  • Karakatsani, AnnaNational and Kapodistrian University of Athens,Hellenic Health Foundation, Athens (author)
  • Peppa, EleniHellenic Health Foundation, Athens (author)
  • Panico, SalvatoreUniversity of Naples Federico II (author)
  • Masala, GiovannaInstitute for Cancer Research, Prevention and Clinical Network (ISPRO) (author)
  • Grioni, SaraIstituto Nazionale dei Tumori (author)
  • Sacerdote, CarlottaCitta' della Salute e della Scienza Hospital-University of Turin (author)
  • Tumino, RosarioProvincial Health Authority (ASP) Ragusa (author)
  • Elias, Sjoerd G.University Medical Center Utrecht,Utrecht University (author)
  • May, Anne M.University Medical Center Utrecht,Utrecht University (author)
  • Borch, Kristin B.UiT The Arctic University of Norway, Tromsø (author)
  • Sandanger, Torkjel M.UiT The Arctic University of Norway, Tromsø (author)
  • Skeie, GuriUiT The Arctic University of Norway, Tromsø (author)
  • Sánchez, Maria JoseCIBER Epidemiology and Public Health (CIBERESP),Andalusian School Of Public Health (EASP),University of Granada (author)
  • Huerta, José MaríaCIBER Epidemiology and Public Health (CIBERESP),Murcia Regional Health Council (author)
  • Sala, NúriaBellvitge Biomedical Research Institute,Catalan Institute of Oncology (author)
  • Gurrea, Aurelio BarricarteHealth Research Institute of Navarra (IDISNA),Navarre Public Health Institute (ISPN),CIBER Epidemiology and Public Health (CIBERESP) (author)
  • Quirós, José RamónPublic Health Directorate (author)
  • Amiano, PilarBasque Regional Health Department,CIBER Epidemiology and Public Health (CIBERESP),Biodonostia Health Research Institute (author)
  • Berntsson, JonnaLund University,Lunds universitet,Personlig patologi och cancerbehandling,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Personalized Pathology & Cancer Therapy,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments(Swepub:lu)jo6056be (author)
  • Drake, IsabelLund University,Lunds universitet,Diabetes - kardiovaskulär sjukdom,Forskargrupper vid Lunds universitet,LUCC: Lunds universitets cancercentrum,Övriga starka forskningsmiljöer,Diabetes - Cardiovascular Disease,Lund University Research Groups,LUCC: Lund University Cancer Centre,Other Strong Research Environments(Swepub:lu)med-ihm (author)
  • van Guelpen, BethanyUmeå universitet,Umeå University,Onkologi,Wallenberg centrum för molekylär medicin vid Umeå universitet (WCMM)(Swepub:umu)beyvan99 (author)
  • Harlid, SophiaUmeå universitet,Umeå University,Onkologi(Swepub:umu)soha0105 (author)
  • Key, TimUniversity of Oxford (author)
  • Weiderpass, ElisabeteInternational Agency for Research on Cancer, World Health Organization (author)
  • Aglago, Elom K.International Agency for Research on Cancer, World Health Organization (author)
  • Cross, Amanda J.Imperial College London (author)
  • Tsilidis, Konstantinos K.University of Ioannina,Imperial College London (author)
  • Riboli, ElioImperial College London (author)
  • Gunter, Marc J.International Agency for Research on Cancer, World Health Organization (author)
  • Leibniz Institute for Prevention Research and Epidemiology - BIPS GmbHGerman Institute of Human Nutrition (creator_code:org_t)

Related titles

  • In:BMC Medicine: Springer Science and Business Media LLC19:11741-7015

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