Evaluation of a risk score based on dietary and lifestyle factors to target a population at risk in colorectal cancer screening

Abstract

BackgroundThe aim of our study was to assess three risk scores to predict lesions, advanced neoplasia (high-risk adenomas and colorectal cancer (CRC)) and CRC in individuals who participate to colorectal cancer screening. MethodsThe data of dietary and lifestyle risk factors were carried out during 2 mass screening campaigns in France (2013–2016) and the FOBT result was collected until December 2018. The colonoscopy result in positive FOBT was recovered. Three risk scores (Betés score, Kaminski score and adapted-HLI) were calculated to detect individuals at risk of lesions. ResultsThe Betés score had an AUROC of 0.63 (95% CI, [0.61–0.66]) for lesions, 0.65 (95% CI, [0.61–0.68]) for advanced neoplasia and 0.65 (95% CI, [0.58–0.72]) for predicting screen-detected CRC.The adapted HLI score had an AUROC of 0.61 (95% CI, [0.58–0.65]) for lesions, 0.61 (95% CI, [0.56–0.65]) for advanced neoplasia and 0.55 (95% CI, [0.45–0.65]) for predicting screen-detected CRC.The Kaminski score had an AUROC of 0.65 (95% CI, [0.63–0.68]) for lesions, 0.65 (95% CI, [0.61–0.68]) for advanced neoplasia and 0.69 (95% CI, [0.62–0.76]) for predicting screen-detected CRC. ConclusionA simple questionnaire based on CRC risk factors could help general practitioners to identify participants with higher risk of significant colorectal lesions and incite them to perform the fecal occult blood test.