Affiliation:
1. Division of Gastroenterology and Hepatology; Shanghai Institute of Digestive Disease; NHC Key Laboratory of Digestive Diseases; State Key Laboratory for Oncogenes and Related Genes; Renji Hospital, School of Medicine Shanghai Jiao Tong University Shanghai China
2. Department of Colorectal Surgery, Fudan University Shanghai Cancer Center Fudan University Shanghai China
3. Department of Gastrointestinal Surgery, Renji Hospital, School of Medicine, Shanghai Jiao Tong University Shanghai China
4. Department of Pathology, Renji Hospital, School of Medicine Shanghai Jiao Tong University Shanghai China
Abstract
AbstractBackgroundColorectal cancer (CRC) incidence has increased among patients aged <50 years. Exploring high‐risk factors and screening high‐risk populations may help lower early‐onset CRC (EO‐CRC) incidence. We developed noninvasive predictive models for EO‐CRC and investigated its risk factors.MethodsThis retrospective multicenter study collected information on 1756 patients (811 patients with EO‐CRC and 945 healthy controls) from two medical centers in China. Sociodemographic features, clinical symptoms, medical and family history, lifestyle, and dietary factors were measured. Patients from one cohort were randomly assigned (8:2) to two groups for model establishment and internal validation, and another independent cohort was used for external validation. Multivariable logistic regression, random forest, and eXtreme Gradient Boosting (XGBoost) were performed to establish noninvasive predictive models for EO‐CRC. Some variables in the model influenced EO‐CRC occurrence and were further analyzed. Multivariable logistic regression analysis yielded adjusted odd ratios (ORs) and 95% confidence intervals (CIs).ResultsAll three models showed good performance, with areas under the receiver operator characteristic curves (AUCs) of 0.82, 0.84, and 0.82 in the internal and 0.78, 0.79, and 0.78 in the external validation cohorts, respectively. Consumption of sweet (OR 2.70, 95% CI 1.89–3.86, P < 0.001) and fried (OR 2.16, 95% CI 1.29–3.62, P < 0.001) foods ≥3 times per week was significantly associated with EO‐CRC occurrence.ConclusionWe established noninvasive predictive models for EO‐CRC and identified multiple nongenetic risk factors, especially sweet and fried foods. The model has good performance and can help predict the occurrence of EO‐CRC in the Chinese population.
Funder
National Key Research and Development Program of China
National Natural Science Foundation of China
Shanghai Municipal Health Commission
Innovative Research Team of High-level Local University in Shanghai
Subject
Gastroenterology,Hepatology
Cited by
2 articles.
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