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Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies
OBJECTIVE: ‘Environmental’ factors associated with colorectal cancer (CRC) risk include modifiable and non-modifiable variables. Whether those with different non-modifiable baseline risks will benefit similarly from reducing their modifiable CRC risks remains unclear. DESIGN: Using 7945 cases and 88...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6904202/ https://www.ncbi.nlm.nih.gov/pubmed/31875139 http://dx.doi.org/10.1136/bmjgast-2019-000339 |
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author | Wang, Xiaoliang O'Connell, Kelli Jeon, Jihyoun Song, Mingyang Hunter, David Hoffmeister, Michael Lin, Yi Berndt, Sonja Brenner, Hermann Chan, Andrew T Chang-Claude, Jenny Gong, Jian Gunter, Marc J Harrison, Tabitha A Hayes, Richard B Joshi, Amit Newcomb, Polly Schoen, Robert Slattery, Martha L Vargas, Ashley Potter, John D Le Marchand, Loic Giovannucci, Edward White, Emily Hsu, Li Peters, Ulrike Du, Mengmeng |
author_facet | Wang, Xiaoliang O'Connell, Kelli Jeon, Jihyoun Song, Mingyang Hunter, David Hoffmeister, Michael Lin, Yi Berndt, Sonja Brenner, Hermann Chan, Andrew T Chang-Claude, Jenny Gong, Jian Gunter, Marc J Harrison, Tabitha A Hayes, Richard B Joshi, Amit Newcomb, Polly Schoen, Robert Slattery, Martha L Vargas, Ashley Potter, John D Le Marchand, Loic Giovannucci, Edward White, Emily Hsu, Li Peters, Ulrike Du, Mengmeng |
author_sort | Wang, Xiaoliang |
collection | PubMed |
description | OBJECTIVE: ‘Environmental’ factors associated with colorectal cancer (CRC) risk include modifiable and non-modifiable variables. Whether those with different non-modifiable baseline risks will benefit similarly from reducing their modifiable CRC risks remains unclear. DESIGN: Using 7945 cases and 8893 controls from 11 population-based studies, we combined 17 risk factors to characterise the overall environmental predisposition to CRC (environmental risk score (E-score)). We estimated the absolute risks (ARs) of CRC of 10 and 30 years across E-score using incidence-rate data from the Surveillance, Epidemiology, and End Results programme. We then combined the modifiable risk factors and estimated ARs across the modifiable risk score, stratified by non-modifiable risk profile based on genetic predisposition, family history and height. RESULTS: Higher E-score was associated with increased CRC risk (OR(quartile), 1.33; 95% CI 1.30 to 1.37). Across E-scores, 30-year ARs of CRC increased from 2.5% in the lowest quartile (Q1) to 5.9% in the highest (Q4) quartile for men, and from 2.1% to 4.5% for women. The modifiable risk score had a stronger association in those with high non-modifiable risk (relative excess risk due to interaction=1.2, 95% CI 0.5 to 1.9). For those in Q4 of non-modifiable risk, a decrease in modifiable risk reduced 30-year ARs from 8.9% to 3.4% for men and from 6.0% to 3.2% for women, a level lower or comparable to the average population risk. CONCLUSIONS: Changes in modifiable risk factors may result in a substantial decline in CRC risk in both sexes. Those with high inherited risk may reap greater benefit from lifestyle modifications. Our results suggested comprehensive evaluation of environmental factors may facilitate CRC risk stratification. |
format | Online Article Text |
id | pubmed-6904202 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-69042022019-12-24 Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies Wang, Xiaoliang O'Connell, Kelli Jeon, Jihyoun Song, Mingyang Hunter, David Hoffmeister, Michael Lin, Yi Berndt, Sonja Brenner, Hermann Chan, Andrew T Chang-Claude, Jenny Gong, Jian Gunter, Marc J Harrison, Tabitha A Hayes, Richard B Joshi, Amit Newcomb, Polly Schoen, Robert Slattery, Martha L Vargas, Ashley Potter, John D Le Marchand, Loic Giovannucci, Edward White, Emily Hsu, Li Peters, Ulrike Du, Mengmeng BMJ Open Gastroenterol Epidemiology OBJECTIVE: ‘Environmental’ factors associated with colorectal cancer (CRC) risk include modifiable and non-modifiable variables. Whether those with different non-modifiable baseline risks will benefit similarly from reducing their modifiable CRC risks remains unclear. DESIGN: Using 7945 cases and 8893 controls from 11 population-based studies, we combined 17 risk factors to characterise the overall environmental predisposition to CRC (environmental risk score (E-score)). We estimated the absolute risks (ARs) of CRC of 10 and 30 years across E-score using incidence-rate data from the Surveillance, Epidemiology, and End Results programme. We then combined the modifiable risk factors and estimated ARs across the modifiable risk score, stratified by non-modifiable risk profile based on genetic predisposition, family history and height. RESULTS: Higher E-score was associated with increased CRC risk (OR(quartile), 1.33; 95% CI 1.30 to 1.37). Across E-scores, 30-year ARs of CRC increased from 2.5% in the lowest quartile (Q1) to 5.9% in the highest (Q4) quartile for men, and from 2.1% to 4.5% for women. The modifiable risk score had a stronger association in those with high non-modifiable risk (relative excess risk due to interaction=1.2, 95% CI 0.5 to 1.9). For those in Q4 of non-modifiable risk, a decrease in modifiable risk reduced 30-year ARs from 8.9% to 3.4% for men and from 6.0% to 3.2% for women, a level lower or comparable to the average population risk. CONCLUSIONS: Changes in modifiable risk factors may result in a substantial decline in CRC risk in both sexes. Those with high inherited risk may reap greater benefit from lifestyle modifications. Our results suggested comprehensive evaluation of environmental factors may facilitate CRC risk stratification. BMJ Publishing Group 2019-12-02 /pmc/articles/PMC6904202/ /pubmed/31875139 http://dx.doi.org/10.1136/bmjgast-2019-000339 Text en © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/. |
spellingShingle | Epidemiology Wang, Xiaoliang O'Connell, Kelli Jeon, Jihyoun Song, Mingyang Hunter, David Hoffmeister, Michael Lin, Yi Berndt, Sonja Brenner, Hermann Chan, Andrew T Chang-Claude, Jenny Gong, Jian Gunter, Marc J Harrison, Tabitha A Hayes, Richard B Joshi, Amit Newcomb, Polly Schoen, Robert Slattery, Martha L Vargas, Ashley Potter, John D Le Marchand, Loic Giovannucci, Edward White, Emily Hsu, Li Peters, Ulrike Du, Mengmeng Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies |
title | Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies |
title_full | Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies |
title_fullStr | Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies |
title_full_unstemmed | Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies |
title_short | Combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies |
title_sort | combined effect of modifiable and non-modifiable risk factors for colorectal cancer risk in a pooled analysis of 11 population-based studies |
topic | Epidemiology |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6904202/ https://www.ncbi.nlm.nih.gov/pubmed/31875139 http://dx.doi.org/10.1136/bmjgast-2019-000339 |
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