Purpose

To mitigate the increasing colorectal cancer (CRC) incidence globally and prevent CRC at the individual level, individual lifestyle information needs to be easily translated into CRC risk assessment. Several CRC risk prediction models exist and their clinical usefulness depends on their ease of use. Our objectives were to assess and externally validate the LiFeCRC score in our independent, unselected population and to investigate the use of simpler food frequency measurements in the score.

Methods

Incidental colon and rectal cancer cases were compared to the general population among 78,580 individuals participating in a longitudinal health study in Norway (HUNT). Vegetable, dairy product, processed meat and sugar/confectionary consumption was scored based on food frequency. The LiFeCRC risk score was calculated for each individual.

Results

Over a median of 10 years following participation in HUNT, colon cancer was diagnosed in 1355 patients and rectal cancer was diagnosed in 473 patients. The LiFeCRC score using food frequencies demonstrated good discrimination in CRC overall (AUC 0.77) and in sex-specific models (AUC men 0.76 and women 0.77) in this population also including individuals ≥ 70 years and patients with diabetes. It performed somewhat better in colon (AUC 0.80) than in rectal cancer (AUC 0.72) and worked best for female colon cancer (AUC 0.81).

Conclusion

Readily available clinical variables and food frequency questions in a modified LiFeCRC score can identify patients at risk of CRC and may improve primary prevention by motivating to lifestyle change or participation in the CRC screening programme.

中文翻译：

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在 HUNT 研究中使用食物频率问题对结直肠癌风险评分 LiFeCRC 进行外部验证

目的

为了缓解全球结直肠癌 (CRC) 发病率不断上升的趋势并在个人层面预防 CRC，需要将个人生活方式信息轻松转化为 CRC 风险评估。存在多种 CRC 风险预测模型，其临床实用性取决于其易用性。我们的目标是评估和外部验证我们独立的、未经选择的人群的 LiFeCRC 评分，并调查评分中更简单的食物频率测量的使用。

方法

在挪威开展的一项纵向健康研究 (HUNT) 中，对 78,580 名个体中的偶发结肠癌和直肠癌病例与一般人群进行了比较。根据食物频率对蔬菜、乳制品、加工肉类和糖/糖果的消费进行评分。计算每个人的 LiFeCRC 风险评分。

结果

参加 HUNT 后的平均 10 年里，有 1355 名患者被诊断出结肠癌，473 名患者被诊断出直肠癌。使用食物频率的 LiFeCRC 评分显示，该人群（还包括 ≥ 70 岁的个体和糖尿病患者）在 CRC 总体（AUC 0.77）和性别特异性模型（AUC 男性 0.76 和女性 0.77）中具有良好的区分度。它在结肠癌（AUC 0.80）中的表现略好于在直肠癌（AUC 0.72）中的表现，并且对女性结肠癌（AUC 0.81）效果最好。

结论

修改后的 LiFeCRC 评分中现成的临床变量和食物频率问题可以识别有 CRC 风险的患者，并可以通过激励生活方式改变或参与 CRC 筛查计划来改善一级预防。