Colorectal cancer risk prediction tool for white men and women without known susceptibility.
OBJECTIVE
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.
Freedman
Andrew N
AN
Division of Cancer Control and Population Sciences, National Cancer Institute, National Institutes of Health, EPN 4005 MSC 7344, Bethesda, MD 20892-7344, USA. Andrew_Freedman@nih.gov
Slattery
Martha L
ML
Ballard-Barbash
Rachel
R
Willis
Gordon
G
Cann
Bette J
BJ
Pee
David
D
Gail
Mitchell H
MH
Pfeiffer
Ruth M
RM
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D015992:Body Mass Index; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D004032:Diet; D005260:Female; D006801:Humans; D007417:Intestinal Polyps; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D016016:Proportional Hazards Models; D012307:Risk Factors; D012812:Sigmoidoscopy; D044465:White People
D000894:Anti-Inflammatory Agents, Non-Steroidal