Risk Model for Colorectal Cancer in Spanish Population Using Environmental and Genetic Factors: Results from the MCC-Spain study
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AuthorIbáñez Sanz, Gemma; Díez Villanueva, Anna; Alonso, M. Henar; Rodríguez Moranta, Francisco; Pérez Gómez, Beatriz; Bustamante, Mariona; Martin, Vicente; Llorca Díaz, Francisco Javier; Amiano, Pilar; Ardanaz, Eva; Tardón, Adonina; Jiménez Moleón, José Juan; Peiró, Rosana; Alguacil, Juan; Navarro, Carmen; Guinó, Elisabet; Binefa, Gemma; Fernández Navarro, Pablo; Espinosa, Anna; [et al.]
Colorectal cancer (CRC) screening of the average risk population is only indicated according to age. We aim to elaborate a model to stratify the risk of CRC by incorporating environmental data and single nucleotide polymorphisms (SNP). The MCC-Spain case-control study included 1336 CRC cases and 2744 controls. Subjects were interviewed on lifestyle factors, family and medical history. Twenty-one CRC susceptibility SNPs were genotyped. The environmental risk model, which included alcohol consumption, obesity, physical activity, red meat and vegetable consumption, and nonsteroidal anti-inflammatory drug use, contributed to CRC with an average per factor OR of 1.36 (95% CI 1.27 to 1.45). Family history of CRC contributed an OR of 2.25 (95% CI 1.87 to 2.72), and each additional SNP contributed an OR of 1.07 (95% CI 1.04 to 1.10). The risk of subjects with more than 25 risk alleles (5th quintile) was 82% higher (OR 1.82, 95% CI 1.11 to 2.98) than subjects with less than 19 alleles (1st quintile). This risk model, with an AUROC curve of 0.63 (95% CI 0.60 to 0.66), could be useful to stratify individuals. Environmental factors had more weight than the genetic score, which should be considered to encourage patients to achieve a healthier lifestyle.