A risk scoring system to predict the individual incidence of early-onset colorectal cancer

Abstract

Background The incidence of early-onset colorectal cancer (EOCRC) is increasing at an alarming rate and further studies are needed to identify risk factors and to develop prevention strategies. Methods Risk factors significantly associated with EOCRC were identified using meta-analysis. An individual risk appraisal model was constructed using the Rothman–Keller model. Next, a group of random data sets was generated using the binomial distribution function method, to determine nodes of risk assessment levels and to identify low, medium, and high risk populations. Results A total of 32,843 EOCRC patients were identified in this study, and nine significant risk factors were identified using meta-analysis, including male sex, Caucasian ethnicity, sedentary lifestyle, inflammatory bowel disease, and high intake of red meat and processed meat. After simulating the risk assessment data of 10,000 subjects, scores of 0 to 0.0018, 0.0018 to 0.0036, and 0.0036 or more were respectively considered as low-, moderate-, and high-risk populations for the EOCRC population based on risk trends from the Rothman–Keller model. Conclusion This model can be used for screening of young adults to predict high risk of EOCRC and will contribute to the primary prevention strategies and the reduction of risk of developing EOCRC.

Delphi Initiative for Early-Onset Colorectal Cancer (DIRECt) International Management Guidelines

“…By using 9 risk factors, the authors simulated 10,000 subjects. 88 However, there was no real-life validation of this study.…”

“…36,[71][72][73][74][75] There is controversial evidence on cigarette smoking, hypertension, chronic kidney disease, dietary patterns, sedentary behavior, and in utero, pediatric, and occupational exposures. 36,[72][73][74][76][77][78][79][80][81][82][83][84][85][86][87] Although many of these proposed risk factors have been combined to produce CRC risk scores, 88,89 no CRC risk score has received formal validation for clinical use.…”

Development and validation of a prediction model for early screening of people at high risk for colorectal cancer

“…A similar study found that in addition to a high intake of red and processed meat, sex, ethnicity, sedentary lifestyle, and inflammatory bowel disease were associated with a low, intermediate, and high risk of early-onset CRC[ 27 ]. The study was a meta-analysis of the literature retrieved from PubMed and Web of Science.…”

Distinct clinical characteristics in stage III rectal cancer among different age groups and treatment outcomes after neoadjuvant chemoradiotherapy

“… 26 , 43 Even earlier screening may strengthen the follow-up of those with a family history. It may be good practice to refer to a risk scoring system, 44 to screen for high-risk groups and perform regular fecal tests for early detection. Screening strategies for the VEO population are still needed to collect and explore more extensive and comprehensive information to establish a suitable screening model.…”