title: Risk Model for Colorectal Cancer in Spanish Population Using Environmental and Genetic Factors: Results from the MCC-Spain study.
abstract: Colorectal cancer (CRC) screening of the average risk population is only indicated according to age. We aim to elaborate a model to stratify the risk of CRC by incorporating environmental data and single nucleotide polymorphisms (SNP). The MCC-Spain case-control study included 1336 CRC cases and 2744 controls. Subjects were interviewed on lifestyle factors, family and medical history. Twenty-one CRC susceptibility SNPs were genotyped. The environmental risk model, which included alcohol consumption, obesity, physical activity, red meat and vegetable consumption, and nonsteroidal anti-inflammatory drug use, contributed to CRC with an average per factor OR of 1.36 (95% CI 1.27 to 1.45). Family history of CRC contributed an OR of 2.25 (95% CI 1.87 to 2.72), and each additional SNP contributed an OR of 1.07 (95% CI 1.04 to 1.10). The risk of subjects with more than 25 risk alleles (5thquintile) was 82% higher (OR 1.82, 95% CI 1.11 to 2.98) than subjects with less than 19 alleles (1stquintile). This risk model, with an AUROC curve of 0.63 (95% CI 0.60 to 0.66), could be useful to stratify individuals. Environmental factors had more weight than the genetic score, which should be considered to encourage patients to achieve a healthier lifestyle.
authors.affiliation: Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Ibáñez-Sanz
authors.affiliation: Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Díez-Villanueva
authors.affiliation: Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: M Henar
authors.initials: MH
authors.lastname: Alonso
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Gastroenterology Department, Bellvitge University Hospital-IDIBELL, L'Hospitalet de Llobregat, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Rodríguez-Moranta
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Environmental and Cancer Epidemiology Department, National Center of Epidemiology - Instituto de Salud Carlos III, Madrid, Spain.|Oncology and Hematology Area, IIS Puerta De Hierro, Cancer Epidemiology Research Group, Madrid, Spain.
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Gómez
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors.forename: Mariona
authors.initials: M
authors.lastname: Bustamante
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Instituto de Biomedicina (IBIOMED). Grupo de investigación en interacciones gen ambiente y salud. Universidad de León, León, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Martin
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Universidad de Cantabria - IDIVAL, Santander, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Llorca
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Public Health Division of Gipuzkoa, Biodonostia Research Institute, San Sebastian, Spain.
authors.forename: Pilar
authors.initials: P
authors.lastname: Amiano
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Navarra Public Health Institute, Navarra, Spain.
authors.forename: Eva
authors.initials: E
authors.lastname: Ardanaz
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|University Institute of Oncology of Asturias (IUOPA), Universidad de Oviedo, Oviedo, Spain.
authors.forename: Adonina
authors.initials: A
authors.lastname: Tardón
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Instituto de Investigación Biosanitaria de Granada (ibs.GRANADA), Hospitales Universitarios de Granada, Granada, Spain.
authors.forename: Jose J
authors.initials: JJ
authors.lastname: Jiménez-Moleón
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana FISABIO-Salud Pública, Valencia.
authors.forename: Rosana
authors.initials: R
authors.lastname: Peiró
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Centre for Research in Health and Environment (CYSMA), Universidad de Huelva, Huelva, Spain.
authors.forename: Juan
authors.initials: J
authors.lastname: Alguacil
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Department of Epidemiology, IMIB-Arrixaca and Department of Health and Social Sciences, Murcia Regional Health Council, Universidad de Murcia, Murcia, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.affiliation: Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Elisabet
authors.initials: E
authors.lastname: Guinó
authors.affiliation: Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain.|CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Binefa
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Environmental and Cancer Epidemiology Department, National Center of Epidemiology - Instituto de Salud Carlos III, Madrid, Spain.|Oncology and Hematology Area, IIS Puerta De Hierro, Cancer Epidemiology Research Group, Madrid, Spain.
authors.forename: Pablo
authors.initials: P
authors.lastname: Fernández-Navarro
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.
authors.forename: Anna
authors.initials: A
authors.lastname: Espinosa
authors.affiliation: Instituto de Biomedicina (IBIOMED). Grupo de investigación en interacciones gen ambiente y salud. Universidad de León, León, Spain.
authors.forename: Verónica
authors.initials: V
authors.lastname: Dávila-Batista
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Instituto de Biomedicina (IBIOMED). Grupo de investigación en interacciones gen ambiente y salud. Universidad de León, León, Spain.
authors.forename: Antonio José
authors.initials: AJ
authors.lastname: Molina
authors.affiliation: Universidad de Cantabria - IDIVAL, Santander, Spain.
authors.forename: Camilo
authors.initials: C
authors.lastname: Palazuelos
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: Gemma
authors.initials: G
authors.lastname: Castaño-Vinyals
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Environmental and Cancer Epidemiology Department, National Center of Epidemiology - Instituto de Salud Carlos III, Madrid, Spain.|Oncology and Hematology Area, IIS Puerta De Hierro, Cancer Epidemiology Research Group, Madrid, Spain.
authors.forename: Nuria
authors.initials: N
authors.lastname: Aragonés
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|ISGlobal Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.|IMIM (Hospital Del Mar Medical Research Institute), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.|School of Public Health, Athens, Greece.
authors.forename: Manolis
authors.initials: M
authors.lastname: Kogevinas
authors.affiliation: CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.|Environmental and Cancer Epidemiology Department, National Center of Epidemiology - Instituto de Salud Carlos III, Madrid, Spain.|Oncology and Hematology Area, IIS Puerta De Hierro, Cancer Epidemiology Research Group, Madrid, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Pollán
authors.affiliation: Cancer Prevention and Control Program, Catalan Institute of Oncology-IDIBELL, L'Hospitalet de Llobregat, Spain. v.moreno@iconcologia.net.|CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain. v.moreno@iconcologia.net.|Department of Clinical Sciences, Faculty of Medicine, University of Barcelona, Barcelona, Spain. v.moreno@iconcologia.net.
authors.forename: Victor
authors.initials: V
authors.lastname: Moreno
mesh_terms: D016022:Case-Control Studies; D015179:Colorectal Neoplasms / Q000453:epidemiology* / Q000235:genetics*; D004781:Environmental Exposure; D005787:Gene Frequency; D006801:Humans; D015233:Models, Statistical; D020641:Polymorphism, Single Nucleotide; D018570:Risk Assessment; D013030:Spain / Q000453:epidemiology