Colorectal cancer and absolute risks

Understanding and communicating epidemiological measures of risk and benefit

“…No absolute risk statistics were reported. The article was criticized by Lawrence et al, 9 who, with the provided information and a 2% baseline risk of colorectal cancer in the global population, estimated the ARR to be quite small, fewer than 1 in 100 people (1%). For the individual patient, this diet might not seem very worthwhile.…”

“…On a global population level on the other hand, a high consumption of fruits and vegetables can potentially prevent approximately 680,000 cases of colorectal cancer and 350,000 global deaths each year. 9 , 10 …”

Relative risk rather than absolute risk reduction should be preferred to sensitise the public to preventive actions

“…As example, what would be the point of reducing by 30% the occurrence of an event affecting 2% of the population? This is exactly what we were confronted to with the COVID-19 pandemic, when policymakers were criticised for putting in place measures to reduce individual freedoms, which were considered excessive in relation to the perception of risk by the public, for a disease whose overall case fatality is in the 2%-4% range 3 -exactly the same magnitude as that of colorectal cancer (CRC) incidence (2%) reported by Lawrence 1 and colleagues, although the GLOBOCAN data were incorrectly cited. 4 Indeed, 2% is the cumulative risk of developing a CRC in the first 74 years of life.…”

“…Nicolas Chapelle , 1,2 Myriam Martel, 3 Alan N Barkun , 3,4 Marc Bardou 5,6 We thank Lawrence and colleagues 1 for their interest in our work, 2 about which they raised some comments as the need of expressing results in absolute rather than relative risks.…”

“…Though shown in uncontrolled studies to predict some CD clinical outcomes, the SES-CD was not expressly designed to predict the durability of sufficient therapeutic response. 1 In Gut, Narula et al present their work optimising the weighting of individual endoscopic features on baseline colonoscopy to predict CD endoscopic remission at 1 year. 2 This group demonstrated that the proposed modified multiplier SES-CD (MM-SES-CD) score better predicted endoscopic remission at 1 year compared with using the original SES-CD (area under the curve (AUC) 0.82 vs 0.60, respectively).…”