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Development of a risk score for colorectal cancer in men
Authors:Driver Jane A  Gaziano J Michael  Gelber Rebecca P  Lee I-Min  Buring Julie E  Kurth Tobias
Affiliation:a The Brigham and Women’s Hospital Divisions of Aging, Boston, Mass.
b Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Mass.
c Department of Epidemiology, Harvard School of Public Health, Boston, Mass.
d Department of Ambulatory Care and Prevention, Harvard Medical School, Boston, Mass.
e Massachusetts Veterans Epidemiology Research Information Center, Boston VA Healthcare System, Boston, Mass.
Abstract:

Background

Colorectal cancer is a common and preventable disease for which screening rates remain unacceptably low.

Methods

We developed a risk scoring system for the development of colorectal cancer among participants in the Physician’s Health Study, a prospective cohort of 21,581 US male physicians who were all free of cancer. Predictors of colorectal cancer were self-reported and identified from the baseline questionnaire. Logistic regression was used to determine the independent predictors of incident colorectal cancer over the follow-up period. Risk scores were created from the sum of the odds ratios of the final predictors and used to divide the cohort into categories of increasing relative risk.

Results

During 20 years of follow-up, 381 cases of colon cancer and 104 cases of rectal cancer developed in the cohort. Age, alcohol use, smoking status, and body mass index were independent significant predictors of colorectal cancer. The point scores were used to define 10 risk groups. Those in the highest risk group (9-10 points) had an odds ratio of 15.29 (6.19-37.81) for colorectal cancer compared with those with the lowest risk. We further stratified scores into 3 risk classes. Compared with those at the lowest relative risk, the odds ratio for colorectal cancer was 3.07 (2.46-3.83) in the intermediate risk group and 5.75 (4.44-7.44) in the highest risk group.

Conclusions

We developed a simple scoring system for colorectal cancer that identifies men at increased relative risk on the basis of age and modifiable factors. This tool should be validated in other populations.
Keywords:Colon cancer   Rectal cancer   Risk score   Risk prediction   Behavioral risk factors
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