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oai:recercat.cat:2445/1742162026-02-20T06:30:19Zcom_2072_1057col_2072_478916col_2072_478917

urn:hdl:2445/174216 Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score Aleksandrova, Krasimira Reichmann, Robin Kaaks, Rudolf Jenab, Mazda Bueno de Mesquita, H. Bas Dahm, Christina C. Eriksen, Anne Kirstine Tjønneland, Anne Artaud, Fanny Boutron-Ruault, Marie-Christine Severi, Gianluca Hüsing, Anika Trichopoulou, Antonia Karakatsani, Anna Peppa, Eleni Panico, Salvatore Masala, Giovanna Grioni, Sara Sacerdote, Carlotta Tumino, Rosario Elias, Sjoerd G. May, Anne M. Borch, Kristin B. Sandanger, Torkjel M. Skeie, Guri Sánchez, María José Huerta Castaño, José María Sala Serra, Núria Barricarte, Aurelio Quirós, José Ramón Amiano, Pilar Berntsson, Jonna Drake, Isabel van Guelpen, Bethany Harlid, Sophia Key, Tim Weiderpass, Elisabete Aglago, Elom K. Cross, Amanda J. Tsilidis, Konstantinos K. Riboli, Elio Gunter, Marc J. Càncer colorectal Estils de vida Colorectal cancer Lifestyles 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. 2021-02-24T12:03:38Z 2021-02-24T12:03:38Z 2021-12-04 2021-02-08T10:34:13Z info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Reproducció del document publicat a: https://doi.org/10.1186/s12916-020-01826-0 BMC Medicine, 2021, vol. 19 https://doi.org/10.1186/s12916-020-01826-0 cc by (c) Aleksandrova et al., 2020 http://creativecommons.org/licenses/by/3.0/es/ info:eu-repo/semantics/openAccess BioMed Central Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))