Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Standard

Development and validation of a lifestyle-based model for colorectal cancer risk prediction : the LiFeCRC score. / Aleksandrova, Krasimira; Reichmann, Robin; Kaaks, Rudolf; Jenab, Mazda; Bueno-de-Mesquita, H. Bas; Dahm, Christina C.; Eriksen, Anne Kirstine; Tjønneland, Anne; Artaud, Fanny; Boutron-Ruault, Marie Christine; Severi, Gianluca; Hüsing, Anika; Trichopoulou, Antonia; Karakatsani, Anna; Peppa, Eleni; Panico, Salvatore; Masala, Giovanna; Grioni, Sara; Sacerdote, Carlotta; Tumino, Rosario; Elias, Sjoerd G.; May, Anne M.; Borch, Kristin B.; Sandanger, Torkjel M.; Skeie, Guri; Sánchez, Maria Jose; Huerta, José María; Sala, Núria; Gurrea, Aurelio Barricarte; Quirós, José Ramón; Amiano, Pilar; Berntsson, Jonna; Drake, Isabel; van Guelpen, Bethany; Harlid, Sophia; Key, Tim; Weiderpass, Elisabete; Aglago, Elom K.; Cross, Amanda J.; Tsilidis, Konstantinos K.; Riboli, Elio; Gunter, Marc J.

In: BMC Medicine, Vol. 19, No. 1, 1, 01.2021.

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Harvard

Aleksandrova, K, Reichmann, R, Kaaks, R, Jenab, M, Bueno-de-Mesquita, HB, Dahm, CC, Eriksen, AK, Tjønneland, A, Artaud, F, Boutron-Ruault, MC, Severi, G, Hüsing, A, Trichopoulou, A, Karakatsani, A, Peppa, E, Panico, S, Masala, G, Grioni, S, Sacerdote, C, Tumino, R, Elias, SG, May, AM, Borch, KB, Sandanger, TM, Skeie, G, Sánchez, MJ, Huerta, JM, Sala, N, Gurrea, AB, Quirós, JR, Amiano, P, Berntsson, J, Drake, I, van Guelpen, B, Harlid, S, Key, T, Weiderpass, E, Aglago, EK, Cross, AJ, Tsilidis, KK, Riboli, E & Gunter, MJ 2021, 'Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score', BMC Medicine, vol. 19, no. 1, 1. https://doi.org/10.1186/s12916-020-01826-0

APA

Aleksandrova, K., Reichmann, R., Kaaks, R., Jenab, M., Bueno-de-Mesquita, H. B., Dahm, C. C., Eriksen, A. K., Tjønneland, A., Artaud, F., Boutron-Ruault, M. C., Severi, G., Hüsing, A., Trichopoulou, A., Karakatsani, A., Peppa, E., Panico, S., Masala, G., Grioni, S., Sacerdote, C., ... Gunter, M. J. (2021). Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score. BMC Medicine, 19(1), [1]. https://doi.org/10.1186/s12916-020-01826-0

CBE

Aleksandrova K, Reichmann R, Kaaks R, Jenab M, Bueno-de-Mesquita HB, Dahm CC, Eriksen AK, Tjønneland A, Artaud F, Boutron-Ruault MC, Severi G, Hüsing A, Trichopoulou A, Karakatsani A, Peppa E, Panico S, Masala G, Grioni S, Sacerdote C, Tumino R, Elias SG, May AM, Borch KB, Sandanger TM, Skeie G, Sánchez MJ, Huerta JM, Sala N, Gurrea AB, Quirós JR, Amiano P, Berntsson J, Drake I, van Guelpen B, Harlid S, Key T, Weiderpass E, Aglago EK, Cross AJ, Tsilidis KK, Riboli E, Gunter MJ. 2021. Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score. BMC Medicine. 19(1):Article 1. https://doi.org/10.1186/s12916-020-01826-0

MLA

Vancouver

Aleksandrova K, Reichmann R, Kaaks R, Jenab M, Bueno-de-Mesquita HB, Dahm CC et al. Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score. BMC Medicine. 2021 Jan;19(1). 1. https://doi.org/10.1186/s12916-020-01826-0

Author

Aleksandrova, Krasimira ; Reichmann, Robin ; Kaaks, Rudolf ; Jenab, Mazda ; Bueno-de-Mesquita, H. Bas ; Dahm, Christina C. ; Eriksen, Anne Kirstine ; Tjønneland, Anne ; Artaud, Fanny ; Boutron-Ruault, Marie Christine ; Severi, Gianluca ; Hüsing, Anika ; Trichopoulou, Antonia ; Karakatsani, Anna ; Peppa, Eleni ; Panico, Salvatore ; Masala, Giovanna ; Grioni, Sara ; Sacerdote, Carlotta ; Tumino, Rosario ; Elias, Sjoerd G. ; May, Anne M. ; Borch, Kristin B. ; Sandanger, Torkjel M. ; Skeie, Guri ; Sánchez, Maria Jose ; Huerta, José María ; Sala, Núria ; Gurrea, Aurelio Barricarte ; Quirós, José Ramón ; Amiano, Pilar ; Berntsson, Jonna ; Drake, Isabel ; van Guelpen, Bethany ; Harlid, Sophia ; Key, Tim ; Weiderpass, Elisabete ; Aglago, Elom K. ; Cross, Amanda J. ; Tsilidis, Konstantinos K. ; Riboli, Elio ; Gunter, Marc J. / Development and validation of a lifestyle-based model for colorectal cancer risk prediction : the LiFeCRC score. In: BMC Medicine. 2021 ; Vol. 19, No. 1.

Bibtex

@article{048c71fa97c14b408ef249bba8a97f74,
title = "Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score",
abstract = "Background: Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate behaviour change. We therefore developed and validated a lifestyle-based CRC risk prediction algorithm in an asymptomatic European population. Methods: The model was based on data from 255,482 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study aged 19 to 70 years who were free of cancer at study baseline (1992–2000) and were followed up to 31 September 2010. The model was validated in a sample comprising 74,403 participants selected among five EPIC centres. Over a median follow-up time of 15 years, there were 3645 and 981 colorectal cancer cases in the derivation and validation samples, respectively. Variable selection algorithms in Cox proportional hazard regression and random survival forest (RSF) were used to identify the best predictors among plausible predictor variables. Measures of discrimination and calibration were calculated in derivation and validation samples. To facilitate model communication, a nomogram and a web-based application were developed. Results: The final selection model included age, waist circumference, height, smoking, alcohol consumption, physical activity, vegetables, dairy products, processed meat, and sugar and confectionary. The risk score demonstrated good discrimination overall and in sex-specific models. Harrell{\textquoteright}s C-index was 0.710 in the derivation cohort and 0.714 in the validation cohort. The model was well calibrated and showed strong agreement between predicted and observed risk. Random survival forest analysis suggested high model robustness. Beyond age, lifestyle data led to improved model performance overall (continuous net reclassification improvement = 0.307 (95% CI 0.264–0.352)), and especially for young individuals below 45 years (continuous net reclassification improvement = 0.364 (95% CI 0.084–0.575)). Conclusions: LiFeCRC score based on age and lifestyle data accurately identifies individuals at risk for incident colorectal cancer in European populations and could contribute to improved prevention through motivating lifestyle change at an individual level.",
keywords = "Cancer prevention, Colorectal cancer, Lifestyle behaviour, Risk prediction, Risk screening",
author = "Krasimira Aleksandrova and Robin Reichmann and Rudolf Kaaks and Mazda Jenab and Bueno-de-Mesquita, {H. Bas} and Dahm, {Christina C.} and Eriksen, {Anne Kirstine} and Anne Tj{\o}nneland and Fanny Artaud and Boutron-Ruault, {Marie Christine} and Gianluca Severi and Anika H{\"u}sing and Antonia Trichopoulou and Anna Karakatsani and Eleni Peppa and Salvatore Panico and Giovanna Masala and Sara Grioni and Carlotta Sacerdote and Rosario Tumino and Elias, {Sjoerd G.} and May, {Anne M.} and Borch, {Kristin B.} and Sandanger, {Torkjel M.} and Guri Skeie and S{\'a}nchez, {Maria Jose} and Huerta, {Jos{\'e} Mar{\'i}a} and N{\'u}ria Sala and Gurrea, {Aurelio Barricarte} and Quir{\'o}s, {Jos{\'e} Ram{\'o}n} and Pilar Amiano and Jonna Berntsson and Isabel Drake and {van Guelpen}, Bethany and Sophia Harlid and Tim Key and Elisabete Weiderpass and Aglago, {Elom K.} and Cross, {Amanda J.} and Tsilidis, {Konstantinos K.} and Elio Riboli and Gunter, {Marc J.}",
year = "2021",
month = jan,
doi = "10.1186/s12916-020-01826-0",
language = "English",
volume = "19",
journal = "B M C Medicine",
issn = "1741-7015",
publisher = "BioMed Central Ltd.",
number = "1",

}

RIS

TY - JOUR

T1 - Development and validation of a lifestyle-based model for colorectal cancer risk prediction

T2 - the LiFeCRC score

AU - Aleksandrova, Krasimira

AU - Reichmann, Robin

AU - Kaaks, Rudolf

AU - Jenab, Mazda

AU - Bueno-de-Mesquita, H. Bas

AU - Dahm, Christina C.

AU - Eriksen, Anne Kirstine

AU - Tjønneland, Anne

AU - Artaud, Fanny

AU - Boutron-Ruault, Marie Christine

AU - Severi, Gianluca

AU - Hüsing, Anika

AU - Trichopoulou, Antonia

AU - Karakatsani, Anna

AU - Peppa, Eleni

AU - Panico, Salvatore

AU - Masala, Giovanna

AU - Grioni, Sara

AU - Sacerdote, Carlotta

AU - Tumino, Rosario

AU - Elias, Sjoerd G.

AU - May, Anne M.

AU - Borch, Kristin B.

AU - Sandanger, Torkjel M.

AU - Skeie, Guri

AU - Sánchez, Maria Jose

AU - Huerta, José María

AU - Sala, Núria

AU - Gurrea, Aurelio Barricarte

AU - Quirós, José Ramón

AU - Amiano, Pilar

AU - Berntsson, Jonna

AU - Drake, Isabel

AU - van Guelpen, Bethany

AU - Harlid, Sophia

AU - Key, Tim

AU - Weiderpass, Elisabete

AU - Aglago, Elom K.

AU - Cross, Amanda J.

AU - Tsilidis, Konstantinos K.

AU - Riboli, Elio

AU - Gunter, Marc J.

PY - 2021/1

Y1 - 2021/1

N2 - Background: Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate behaviour change. We therefore developed and validated a lifestyle-based CRC risk prediction algorithm in an asymptomatic European population. Methods: The model was based on data from 255,482 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study aged 19 to 70 years who were free of cancer at study baseline (1992–2000) and were followed up to 31 September 2010. The model was validated in a sample comprising 74,403 participants selected among five EPIC centres. Over a median follow-up time of 15 years, there were 3645 and 981 colorectal cancer cases in the derivation and validation samples, respectively. Variable selection algorithms in Cox proportional hazard regression and random survival forest (RSF) were used to identify the best predictors among plausible predictor variables. Measures of discrimination and calibration were calculated in derivation and validation samples. To facilitate model communication, a nomogram and a web-based application were developed. Results: The final selection model included age, waist circumference, height, smoking, alcohol consumption, physical activity, vegetables, dairy products, processed meat, and sugar and confectionary. The risk score demonstrated good discrimination overall and in sex-specific models. Harrell’s C-index was 0.710 in the derivation cohort and 0.714 in the validation cohort. The model was well calibrated and showed strong agreement between predicted and observed risk. Random survival forest analysis suggested high model robustness. Beyond age, lifestyle data led to improved model performance overall (continuous net reclassification improvement = 0.307 (95% CI 0.264–0.352)), and especially for young individuals below 45 years (continuous net reclassification improvement = 0.364 (95% CI 0.084–0.575)). Conclusions: LiFeCRC score based on age and lifestyle data accurately identifies individuals at risk for incident colorectal cancer in European populations and could contribute to improved prevention through motivating lifestyle change at an individual level.

AB - Background: Nutrition and lifestyle have been long established as risk factors for colorectal cancer (CRC). Modifiable lifestyle behaviours bear potential to minimize long-term CRC risk; however, translation of lifestyle information into individualized CRC risk assessment has not been implemented. Lifestyle-based risk models may aid the identification of high-risk individuals, guide referral to screening and motivate behaviour change. We therefore developed and validated a lifestyle-based CRC risk prediction algorithm in an asymptomatic European population. Methods: The model was based on data from 255,482 participants in the European Prospective Investigation into Cancer and Nutrition (EPIC) study aged 19 to 70 years who were free of cancer at study baseline (1992–2000) and were followed up to 31 September 2010. The model was validated in a sample comprising 74,403 participants selected among five EPIC centres. Over a median follow-up time of 15 years, there were 3645 and 981 colorectal cancer cases in the derivation and validation samples, respectively. Variable selection algorithms in Cox proportional hazard regression and random survival forest (RSF) were used to identify the best predictors among plausible predictor variables. Measures of discrimination and calibration were calculated in derivation and validation samples. To facilitate model communication, a nomogram and a web-based application were developed. Results: The final selection model included age, waist circumference, height, smoking, alcohol consumption, physical activity, vegetables, dairy products, processed meat, and sugar and confectionary. The risk score demonstrated good discrimination overall and in sex-specific models. Harrell’s C-index was 0.710 in the derivation cohort and 0.714 in the validation cohort. The model was well calibrated and showed strong agreement between predicted and observed risk. Random survival forest analysis suggested high model robustness. Beyond age, lifestyle data led to improved model performance overall (continuous net reclassification improvement = 0.307 (95% CI 0.264–0.352)), and especially for young individuals below 45 years (continuous net reclassification improvement = 0.364 (95% CI 0.084–0.575)). Conclusions: LiFeCRC score based on age and lifestyle data accurately identifies individuals at risk for incident colorectal cancer in European populations and could contribute to improved prevention through motivating lifestyle change at an individual level.

KW - Cancer prevention

KW - Colorectal cancer

KW - Lifestyle behaviour

KW - Risk prediction

KW - Risk screening

UR - http://www.scopus.com/inward/record.url?scp=85098547972&partnerID=8YFLogxK

U2 - 10.1186/s12916-020-01826-0

DO - 10.1186/s12916-020-01826-0

M3 - Journal article

C2 - 33390155

AN - SCOPUS:85098547972

VL - 19

JO - B M C Medicine

JF - B M C Medicine

SN - 1741-7015

IS - 1

M1 - 1

ER -