Background & Aims

Estimates of absolute risk of colorectal cancer (CRC) are needed to facilitate communication and better inform the public about the potentials and limits of cancer prevention.

Methods

Using data from a large population-based case-control study in Germany (Darmkrebs: Chancen der Verhütung durch Screening [DACHS] study, which began in 2003) and population registry data, we calculated 30-year absolute risk estimates for development of CRC based on a healthy lifestyle score (derived from 5 modifiable lifestyle factors: smoking, alcohol consumption, diet, physical activity, and body fatness), a polygenic risk score (based on 90 single-nucleotide polymorphisms), and colonoscopy history.

Results

We analyzed data from 4220 patients with CRC and 3338 individuals without CRC. Adherence to a healthy lifestyle and colonoscopy in the preceding 10 years were associated with a reduced relative risk of CRC in men and women. We observed a higher CRC risk in participants with high or intermediate genetic risk scores. For 50-year-old men and women without a colonoscopy, the absolute risk of CRC varied according to the polygenic risk score and the healthy lifestyle score (men, 3.5%–13.4%; women, 2.5%–10.6%). For 50-year-old men and women with a colonoscopy, the absolute risk of developing CRC was much lower but still varied according to the polygenic risk score and the healthy lifestyle score (men, 1.2%–4.8%; women, 0.9%–4.2%). Among all risk factor profiles, the 30-year absolute risk estimates consistently decreased with adherence to a healthy lifestyle.

Conclusions

In a population-based study, we found that a colonoscopy can drastically reduce the absolute risk of CRC and that the genetically predetermined risk of CRC can be further reduced by adherence to a healthy lifestyle. Our results show the magnitude of CRC prevention possible through colonoscopy and lifestyle at a predefined genetic risk. This observational study has been registered in the German Clinical Trials Register (DRKS00011793), which is a primary registry in the World Health Organization Registry Network.

中文翻译：

---

在一项基于人群的研究中，根据健康的生活方式，遗传风险和结肠镜检查状况估算大肠癌的绝对风险。

背景与目标

需要估计结直肠癌（CRC）的绝对风险，以促进沟通并更好地向公众宣传癌症预防的潜力和局限性。

方法

利用德国一项基于人群的大型病例对照研究（Darmkrebs：Chancen derVerhütungdurch Screening [DACHS]研究始于2003年）的数据和人口登记数据，我们计算了30年的绝对风险估计值，用于基于CRC的研究健康的生活方式评分（来自5种可改变的生活方式因素：吸烟，饮酒，饮食，体育锻炼和身体肥胖），多基因风险评分（基于90个单核苷酸多态性）和结肠镜检查史。

结果

我们分析了4220例CRC患者和3338例无CRC患者的数据。在过去的10年中，坚持健康的生活方式和进行结肠镜检查与降低男性和女性患CRC的相对风险有关。我们观察到具有较高或中等遗传风险评分的参与者的CRC风险较高。对于没有结肠镜检查的50岁男性和女性，CRC的绝对风险根据多基因风险评分和健康的生活方式评分而有所不同（男性为3.5％–13.4％；女性为2.5％–10.6％）。对于接受结肠镜检查的50岁男性和女性，发生CRC的绝对风险要低得多，但仍会根据多基因风险评分和健康的生活方式评分而有所不同（男性为1.2％–4.8％；女性为0.9％– 4.2％）。在所有风险因素方面，

结论

在一项基于人群的研究中，我们发现结肠镜检查可以大大降低CRC的绝对风险，并且通过坚持健康的生活方式可以进一步降低CRC的遗传学预定风险。我们的研究结果表明，通过结肠镜检查和生活方式可以在预定的遗传风险下预防CRC。这项观察性研究已在德国临床试验注册簿（DRKS00011793）中进行了注册，该注册簿是世界卫生组织注册网络中的主要注册机构。