| Title: | Effectiveness of colorectal cancer screening integrating non-genetic and genetic risk: a prospective study based on UK Biobank data. |
| Journal: | Cancer Biology & Medicine |
| Published: | 20 Jun 2024 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/38899940/ |
| DOI: | https://doi.org/10.20892/j.issn.2095-3941.2024.0096 |
| URL: | https://www.cancerbiomed.org/content/cbm/early/2024/06/20/j.issn.2095-3941.2024.0096.full.pdf |
Publication 11823
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Abstract
OBJECTIVE: Few studies have evaluated the benefits of colorectal cancer (CRC) screening integrating both non-genetic and genetic risk factors. Here, we aimed to integrate an existing non-genetic risk model (QCancer-10) and a 139-variant polygenic risk score to evaluate the effectiveness of screening on CRC incidence and mortality.</p>
METHODS: We applied the integrated model to calculate 10-year CRC risk for 430,908 participants in the UK Biobank, and divided the participants into low-, intermediate-, and high-risk groups. We calculated the screening-associated hazard ratios (HRs) and absolute risk reductions (ARRs) for CRC incidence and mortality according to risk stratification.</p>
RESULTS: During a median follow-up of 11.03 years and 12.60 years, we observed 5,158 CRC cases and 1,487 CRC deaths, respectively. CRC incidence and mortality were significantly lower among screened than non-screened participants in both the intermediate- and high-risk groups [incidence: HR: 0.87, 95% confidence interval (CI): 0.81-0.94; 0.81, 0.73-0.90; mortality: 0.75, 0.64-0.87; 0.70, 0.58-0.85], which composed approximately 60% of the study population. The ARRs (95% CI) were 0.17 (0.11-0.24) and 0.43 (0.24-0.61), respectively, for CRC incidence, and 0.08 (0.05-0.11) and 0.24 (0.15-0.33), respectively, for mortality. Screening did not significantly reduce the relative or absolute risk of CRC incidence and mortality in the low-risk group. Further analysis revealed that screening was most effective for men and individuals with distal CRC among the intermediate to high-risk groups.</p>
CONCLUSIONS: After integrating both genetic and non-genetic factors, our findings provided priority evidence of risk-stratified CRC screening and valuable insights for the rational allocation of health resources.</p>
8 Authors
- Yu Zhang
- Chao Sheng
- Zhangyan Lyu
- Hongji Dai
- Fangfang Song
- Fengju Song
- Yubei Huang
- Kexin Chen
1 Application
| Application ID | Title |
|---|---|
| 76092 | Uncovering the causal mechanism between environmental exposure and cancer by integrating exposome, genomic, clinical phenomic and radiomic data |
Enabling scientific discoveries that improve human health