Abstract
To build a simple predictive model as a guide to stratify average‐risk population for colonoscopy examinations. We collected data from 92 923 males without a prior history of cancer enrolled in the Kailuan Cohort Study of China. Risk factors included in the evaluation of colorectal cancer (CRC) were collected by questionnaire‐based interviews at the baseline. Logistic regression coefficients for incident CRC predictors were converted into risk scores by the absolute value of the smallest coefficient in the model and rounding up to the nearest integer. Receiver operating characteristic (ROC) analysis with the leave‐one‐out cross‐validation method was applied to evaluate model performance. In the 10‐year follow‐up, 353 CRC patients were in the cohort. Age, alcohol consumption, waist circumference, occupational sitting time, and history of diabetes were selected for the scoring system, and the adjusted area under the ROC was 0.66. Population in the highest risk group (16‐19 points) had a 33.12‐fold (95% CI: 13.44‐81.59) higher risk of CRC than those in the lowest risk group. When we defined 13 points as the cut‐off, the sensitivity and specificity of the scoring system for CRC were 67.99% and 62.42%, respectively. A simple scoring system for CRC has been developed to identify men at an increased relative risk of CRC within 10 years using several well‐established risk factors, which allows selection of asymptomatic candidates for priority of CRC screening and saving the health resource in cancer prevention and control.
Highlights
Colorectal cancer (CRC) is the fourth most common cancer in men and the third most common cancer in women in China,[1] with an age-standardized incidence rate of 18.02 per 100 000 in 2015; CRC is the fifth most common cause of death from cancer with an age-standardized mortality rate of 8.21 per 100 000
The risk factors identified in our model for CRC are consistent with the findings of other multivariable analyses in men,[16,17,18,19] women,[20,21,22] and both sexes.[17,18,23,24]
Regarding age-related risk stratification, our study showed that older age was the main risk factor for CRC and that the risk was more than sixteen times higher in the age group of more than 60 years than in the age group of less than 40 years
Summary
This study was funded by the National Key R&D Program of China (Nos. 2018YFC1315000/2018YFC1315001 and 2016YFC1302500/2016YFC1302503), the Chinese Academy of Medical Sciences (CAMS) Innovation Fund for Medical Sciences (No 2017-I2M-1-006 and 2019I2M-2-002), the Training Programme Foundation for the Talents in Beijing City (No 2017000021223TD05), the National Natural Science Foundation of China (No 81673265, 81703298).
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