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@ARTICLE{Jeon:135960,
      author       = {J. Jeon and M. Du and R. E. Schoen and M. Hoffmeister$^*$
                      and P. A. Newcomb and S. I. Berndt and B. Caan and P. T.
                      Campbell and A. T. Chan and J. Chang-Claude$^*$ and G. G.
                      Giles and J. Gong and T. A. Harrison and J. R. Huyghe and E.
                      J. Jacobs and L. Li and Y. Lin and L. Le Marchand and J. D.
                      Potter and C. Qu and S. A. Bien and N. Zubair and R. J.
                      Macinnis and D. D. Buchanan and J. L. Hopper and Y. Cao and
                      R. Nishihara and G. Rennert and M. L. Slattery and D. C.
                      Thomas and M. O. Woods and R. L. Prentice and S. B. Gruber
                      and Y. Zheng and H. Brenner$^*$ and R. B. Hayes and E. White
                      and U. Peters and L. Hsu},
      collaboration = {C. T. S. a. G. a. E. o. C. C. Consortium},
      title        = {{D}etermining {R}isk of {C}olorectal {C}ancer and
                      {S}tarting {A}ge of {S}creening {B}ased on {L}ifestyle,
                      {E}nvironmental, and {G}enetic {F}actors.},
      journal      = {Gastroenterology},
      volume       = {154},
      number       = {8},
      issn         = {0016-5085},
      address      = {Stanford, Calif.},
      publisher    = {HighWire Press},
      reportid     = {DKFZ-2018-00697},
      pages        = {2152 - 2164.e19},
      year         = {2018},
      abstract     = {Guidelines for initiating colorectal cancer (CRC) screening
                      are based on family history but do not consider lifestyle,
                      environmental, or genetic risk factors. We developed models
                      to determine risk of CRC, based on lifestyle and
                      environmental factors and genetic variants, and to identify
                      an optimal age to begin screening.We collected data from
                      9748 CRC cases and 10,590 controls in the Genetics and
                      Epidemiology of Colorectal Cancer Consortium and the
                      Colorectal Transdisciplinary study, from 1992 through 2005.
                      Half of the participants were used to develop the risk
                      determination model and the other half were used to evaluate
                      the discriminatory accuracy (validation set). Models of CRC
                      risk were created based on family history, 19 lifestyle and
                      environmental factors (E-score), and 63 CRC-associated
                      single-nucleotide polymorphisms identified in genome-wide
                      association studies (G-score). We evaluated the
                      discriminatory accuracy of the models by calculating area
                      under the receiver operating characteristic curve values,
                      adjusting for study, age, and endoscopy history for the
                      validation set. We used the models to project the 10-year
                      absolute risk of CRC for a given risk profile and recommend
                      ages to begin screening in comparison to CRC risk for an
                      average individual at 50 years of age, using external
                      population incidence rates for non-Hispanic whites from the
                      Surveillance, Epidemiology, and End Results program
                      registry.In our models, E-score and G-score each determined
                      risk of CRC with greater accuracy than family history. A
                      model that combined both scores and family history estimated
                      CRC risk with an area under the receiver operating
                      characteristic curve value of 0.63 $(95\%$ confidence
                      interval, 0.62-0.64) for men and 0.62 $(95\%$ confidence
                      interval, 0.61-0.63) for women; area under the receiver
                      operating characteristic curve values based on only family
                      history ranged from 0.53 to 0.54 and those based only
                      E-score or G-score ranged from 0.59 to 0.60. Although
                      screening is recommended to begin at age 50 years for
                      individuals with no family history of CRC, starting ages
                      calculated based on combined E-score and G-score differed by
                      12 years for men and 14 for women, for individuals with
                      the highest vs the lowest $10\%$ of risk.We used data from
                      2 large international consortia to develop CRC risk
                      calculation models that included genetic and environmental
                      factors along with family history. These determine risk of
                      CRC and starting ages for screening with greater accuracy
                      than the family history only model, which is based on the
                      current screening guideline. These scoring systems might
                      serve as a first step toward developing individualized CRC
                      prevention strategies.},
      cin          = {C070 / G110 / C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331 /
                      I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:29458155},
      pmc          = {pmc:PMC5985207},
      doi          = {10.1053/j.gastro.2018.02.021},
      url          = {https://inrepo02.dkfz.de/record/135960},
}