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dc.contributor.authorAleksandrova, Krasimira
dc.contributor.authorSánchez Pérez, María José 
dc.date.accessioned2021-02-15T08:54:24Z
dc.date.available2021-02-15T08:54:24Z
dc.date.issued2020
dc.identifier.citationAleksandrova, K., Reichmann, R., Kaaks, R. et al. Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the LiFeCRC score. BMC Med 19, 1 (2021). https://doi.org/10.1186/s12916-020-01826-0es_ES
dc.identifier.urihttp://hdl.handle.net/10481/66543
dc.description.abstractBackground: 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.es_ES
dc.description.sponsorshipGerman Research Foundation (DFG) AL 1784/3-1es_ES
dc.description.sponsorshipEuropean Commission European Commission Joint Research Centrees_ES
dc.description.sponsorshipInternational Agency for Research on Canceres_ES
dc.description.sponsorshipDanish Cancer Societyes_ES
dc.description.sponsorshipLigue Contre le Cancer (France)es_ES
dc.description.sponsorshipInstitut Gustave Roussy (France)es_ES
dc.description.sponsorshipMutuelle Generale de l'Education Nationale (France)es_ES
dc.description.sponsorshipInstitut National de la Sante et de la Recherche Medicale (Inserm)es_ES
dc.description.sponsorshipDeutsche Krebshilfe, Deutsches Krebsforschungszentrum (DKFZ) (Germany)es_ES
dc.description.sponsorshipFederal Ministry of Education & Research (BMBF)es_ES
dc.description.sponsorshipHellenic Health Foundation (Greece)es_ES
dc.description.sponsorshipAssociazione Italiana per la Ricerca sul Cancro (AIRC)es_ES
dc.description.sponsorshipConsiglio Nazionale delle Ricerche (CNR)es_ES
dc.description.sponsorshipNetherlands Governmentes_ES
dc.description.sponsorshipWorld Cancer Research Fund International (WCRF)es_ES
dc.description.sponsorshipInstituto de Salud Carlos III PI13/00061 PI13/01162es_ES
dc.description.sponsorshipJunta de Andaluciaes_ES
dc.description.sponsorshipRegional Government of Asturias (Spain)es_ES
dc.description.sponsorshipRegional Government of Basque Country (Spain)es_ES
dc.description.sponsorshipRegional Government of Murcia (Spain) 6236es_ES
dc.description.sponsorshipRegional Government of Navarra (Spain)es_ES
dc.description.sponsorshipRegional Government of Catalonia (Catalan Institute of Oncology -ICO-IDIBELL) (Spain)es_ES
dc.description.sponsorshipSwedish Cancer Societyes_ES
dc.description.sponsorshipSwedish Research Counciles_ES
dc.description.sponsorshipCounty Council of Skane (Sweden)es_ES
dc.description.sponsorshipCounty Council of Vasterbotten (Sweden)es_ES
dc.description.sponsorshipCancer Research UK C864/A14136 C8221/A19170es_ES
dc.description.sponsorshipUK Research & Innovation (UKRI) Medical Research Council UK (MRC) MR/N003284/1 MC-UU_12015/1 MR/M012190/1es_ES
dc.description.sponsorshipProjekt DEALes_ES
dc.language.isoenges_ES
dc.publisherBMCes_ES
dc.rightsAtribución 3.0 España*
dc.rights.urihttp://creativecommons.org/licenses/by/3.0/es/*
dc.subjectColorectal canceres_ES
dc.subjectRisk predictiones_ES
dc.subjectLifestyle behavioures_ES
dc.subjectRisk screeninges_ES
dc.subjectCancer preventiones_ES
dc.titleDevelopment and validation of a lifestylebased model for colorectal cancer risk prediction: the LiFeCRC scorees_ES
dc.typeinfo:eu-repo/semantics/articlees_ES
dc.rights.accessRightsinfo:eu-repo/semantics/openAccesses_ES
dc.identifier.doi10.1186/s12916-020-01826-0


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