title: Incorporating non-genetic risk factors and behavioural modifications into risk prediction models for colorectal cancer.
abstract: BACKGROUND
  Epidemiological studies have identified potentially modifiable risks for colorectal cancer, including alcohol intake, diet and a sedentary lifestyle. Modelling these environmental factors alongside genetic risk is critical in obtaining accurate estimates of disease risk and improving our understanding of behavioural modifications.
  
  
  METHODS
  14 independent single nucleotide polymorphisms identified though GWAS studies and reported on by the international consortium COGENT were used to model genetic disease risk at a population level. Six well validated environmental risks were selected for modelling together with the genetic risk factors (alcohol intake; smoking; exercise levels; BMI; fibre intake and consumption of red and processed meat). Through a simulation study using risk modelling software, we assessed the potential impact of behavioural modifications on disease risk.
  
  
  RESULTS
  Modelling the genetic data alone leads to 24% of the population being classified as reduced risk; 60% average risk; 10% elevated risk and 6% high risk for colorectal cancer. Adding alcohol consumption to the model reduced the elevated and high risk categories to 9% and 5% respectively. The simulation study suggests that a substantial proportion of individuals could reduce their disease risk profile by altering their behaviour, including reclassification of over 62% of heavy drinkers.
  
  
  CONCLUSIONS
  Modelling lifestyle factors alongside genetic risk can provide useful strategies to select individuals for screening for colorectal cancer risk.
  
  
  CONCLUSIONS
  Quantifying the impact of moderating behaviour, particularly related to alcohol intake and obesity levels, is beneficial for informing health campaigns and tailoring prevention strategies.
authors: Division of Genetics and Molecular Medicine, King's College London, United Kingdom.
authors: Jane M
authors: JM
authors: Yarnall
authors: Daniel J M
authors: DJ
authors: Crouch
authors: Cathryn M
authors: CM
authors: Lewis
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000209:etiology; D004032:Diet / Q000009:adverse effects; D004043:Dietary Fiber / Q000009:adverse effects; D004781:Environmental Exposure; D015444:Exercise; D006801:Humans; D007342:Insurance Benefits / Q000706:statistics & numerical data*; D008019:Life Style; D008460:Meat / Q000009:adverse effects; D016017:Odds Ratio; D012307:Risk Factors; D040242:Risk Reduction Behavior; D012907:Smoking / Q000009:adverse effects