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한빛사논문
한빛사논문, 상위피인용논문
- 조회1,958
Gastroenterology, Available online 17 February 2018 | https://doi.org/10.1053/j.gastro.2018.02.021
Determining Risk of Colorectal Cancer and Starting Age of Screening Based on Lifestyle, Environmental, and Genetic Factors
Jihyoun Jeon, PhD1,*, Mengmeng Du, ScD2, Robert E. Schoen, MD, MPH3, Michael Hoffmeister, PhD4,5,6, Polly A. Newcomb, PhD7, Sonja I. Berndt, PharmD, PhD8, Bette Caan, DrPH9, Peter T. Campbell, PhD10, Andrew T. Chan, MD11,12,13, Jenny ChangClaude, PhD4,5,6, Graham G. Giles, PhD14, Jian Gong, PhD7, Tabitha A. Harrison, MPH7, Jeroen R. Huyghe, PhD7, Eric J. Jacobs, PhD10, Li Li, MD, PhD15, Yi Lin, MS7, Loic Le Marchand, MD, PhD16, John D. Potter, MD, PhD7, Flora Qu, MS7, Stephanie A. Bien, PhD7, Niha Zubair, PhD7, Robert J. Macinnis, PhD14, Daniel D. Buchanan, PhD17,18,19, John L. Hopper, PhD18,20, Yin Cao, DSc11,12, Reiko Nishihara, PhD11, Gad Rennert, MD, PhD21, Martha L. Slattery, PhD22, Duncan C. Thomas, PhD23, Michael O. Woods, PhD24, Ross L. Prentice, PhD7, Stephen B. Gruber, MD, PhD25, Yingye Zheng, PhD7, Hermann Brenner, MD4,5,6, Richard B. Hayes, DDS, PhD26, Emily White, PhD7, Ulrike Peters, PhD7,*, Li Hsu, PhD7,* on behalf of the Colorectal Transdisciplinary (CORECT) Study and Genetics and Epidemiology of Colorectal Cancer Consortium (GECCO)
1 Department of Epidemiology, University of Michigan, Ann Arbor, USA
1 Department of Epidemiology, University of Michigan, Ann Arbor, USA
2 Memorial Sloan Kettering, New York, USA
3 Department of Medicine and Epidemiology, University of Pittsburgh Medical Center, Pittsburgh, USA
4 Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
5 Division of Preventive Oncology, German Cancer Research Center (DKFZ) and National Center for Tumor Diseases (NCT), Heidelberg, Germany
6 German Cancer Consortium (DKTK), German Cancer Research Center (DKFZ), Heidelberg, Germany
7 Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, USA
8 Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, USA
9 Division of Research, Kaiser Permanente Medical Care Program, Oakland, USA
10 Epidemiology Research Program, American Cancer Society, Atlanta, USA
11 Clinical and Translational Epidemiology Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA
12 Division of Gastroenterology, Massachusetts General Hospital and Harvard Medical School, Boston, USA
13 Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
14 Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, and Centre for Epidemiology and Biostatistics, School of Global and Population Health, University of Melbourne, Melbourne, Australia
15 Case Western Reserve University, Cleveland, USA
16 Epidemiology Program, University of Hawaii Cancer Center, Honolulu, USA
17 Colorectal Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Victoria, Australia;
18 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia;
19 Genetic Medicine and Family Cancer Clinic, The Royal Melbourne Hospital, Parkville, Victoria, Australia
20 Department of Epidemiology, School of Public Health and Institute of Health and Environment, Seoul National University, Seoul, South Korea
21 Carmel Medical Center, Haifa, Israel
22 Department of Internal Medicine, University of Utah Health Sciences Center, Salt Lake City, USA
23 Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
24 Memorial University of Newfoundland, St. John's, Canada
25 USC Norris Comprehensive Cancer Center, University of Southern California, Los Angeles, USA
26 Division of Epidemiology, Department of Population Health, New York University School of Medicine, New York, USA
*Corresponding Authors:
*Corresponding Authors:
Jihyoun Jeon: 1415 Washington Heights, Ann Arbor MI 48109-2029.
Ulrike Peters: 1100 Fairview Ave. N., M4-B402, Fred Hutchinson Cancer Research Center, Seattle, WA 98109
Li Hsu: 1100 Fairview Ave. N., M2-B500, Fred Hutchinson Cancer Research Center, Seattle, WA 98109
Abstract
Background & Aims
Guidelines for initiating colorectal cancer (CRC) screening are based on family history but do not consider lifestyle, environmental, or genetic risk factors. We developed models to determine risk of CRC, based on lifestyle and environmental factors and genetic variants, and to identify an optimal age to begin screening.
Methods
We collected data from 9748 CRC cases and 10,590 controls in the Genetics and Epidemiology of Colorectal Cancer Consortium and the Colorectal Transdisciplinary study, from 1992 through 2005. Half of the participants were used to develop the risk determination model and the other half were used to evaluate the discriminatory accuracy (validation set). Models of CRC risk were created based on family history, 19 lifestyle and environmental factors (E-score), and 63 CRC-associated single-nucleotide polymorphisms identified in genome-wide association studies (G-score). We evaluated the discriminatory accuracy of the models by calculating area under the receiver operating characteristic curve (AUC) values, adjusting for study, age, and endoscopy findings for the validation set. We used the models to project the 10-year absolute risk of CRC for a given risk profile and recommend ages to begin screening, in comparison to CRC risk for an average individual at 50 years of age, using external population incidence rates for non-Hispanic whites from the Surveillance, Epidemiology, and End Results Program registry.
Results
In our models, E-score and G-score each determined risk of CRC with greater accuracy than family history. A model that combined both scores and family history estimated CRC risk with an AUC value of 0.63 (95% CI, 0.62?0.64) for men and 0.62 (95% CI, 0.61?0.63) for women; AUC values based on only family history ranged from 0.53 to 0.54 and those based only E-score or G-score ranged from 0.59 to 0.60. Although screening is recommended to begin at age 50 years for individuals with no family history of CRC, starting ages calculated based on combined E-score and G-score differed by 12 years for men and 14 for women, for individuals with the highest vs the lowest 10% of risk.
Conclusions
We used data from 2 large international consortia to develop CRC risk calculation models that included genetic and environmental factors along with family history. These determine risk of CRC and starting ages for screening with greater accuracy than the family history only model, which is based on the current screening guideline. These scoring systems might serve as a first step toward developing individualized CRC prevention strategies.
KEY WORDS: colon cancer; GECCO, CORECT, colonoscopy
논문정보
- Research article
- 2018년 02월 (BRIC 등록일 2018-03-19)
- 국내+국외 연구진
- 60회 이상 인용된 논문 (상위피인용논문 등록일 2020-08-25)
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