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      author       = {P. Carr$^*$ and K. Weigl$^*$ and D. Edelmann$^*$ and L.
                      Jansen$^*$ and J. Chang-Claude$^*$ and H. Brenner$^*$ and M.
      title        = {{E}stimation of {A}bsolute {R}isk of {C}olorectal {C}ancer
                      {B}ased on {H}ealthy {L}ifestyle, {G}enetic {R}isk, and
                      {C}olonoscopy {S}tatus in a {P}opulation-based {S}tudy.},
      journal      = {Gastroenterology},
      volume       = {159},
      number       = {1},
      issn         = {0016-5085},
      address      = {Philadelphia, Pa. [u.a.]},
      publisher    = {Saunders},
      reportid     = {DKFZ-2020-00579},
      pages        = {129-138.e9},
      year         = {2020},
      note         = {2020 Jul;159(1):129-138.e9#EA:C070#LA:C070#},
      abstract     = {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.Using data from a large population-based
                      case-control study in Germany (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.We analyzed data from 4220 patients with CRC and
                      3338 individuals without CRC. Adherence to a healthy
                      lifestyle and colonoscopy in the preceding 10 y 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, $3.5\%-13.4\%$ and 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, $1.2\%-4.8\%$ and
                      women, $0.9\%-4.2\%).$ Among all risk factor profiles, the
                      30-y absolute risk estimates consistently decreased with
                      adherence to a healthy lifestyle.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.},
      cin          = {C070 / C060 / C020 / C120 / HD01},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)C060-20160331 /
                      I:(DE-He78)C020-20160331 / I:(DE-He78)C120-20160331 /
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32179093},
      doi          = {10.1053/j.gastro.2020.03.016},
      url          = {https://inrepo02.dkfz.de/record/154118},