评估环境和多基因风险评分的使用,以告知结直肠癌基于风险的监测间隔
Rebecca Landy1, Hormuzd A Katki1, Wen-Yi Huang1
1Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.
Clinical and translational gastroenterology
|December 29, 2024
概括
一个新的风险模型可以识别需要更短的结直肠癌监测的个体. 这种个性化的方法考虑了超越腺瘤特征的因素,改善了风险评估,以更好地管理患者.
科学领域:
- 胃肠道学和瘤学
- 遗传学和流行病学
背景情况:
- 美国目前的结肠镜监测间隔仅基于腺瘤特征.
- 这种方法不考虑结直肠癌的其他重大风险因素.
研究的目的:
- 调查是否包括人口,环境和遗传因素的综合风险模型可以个性化结肠镜监测间隔.
- 为个性化患者护理应用"平等管理同等风险"框架.
主要方法:
- 利用了来自前列腺,肺部,结肠直肠和卵巢癌查试验的14069名参与者的数据.
- 使用结肠镜检查结果,基线特征,生活方式因素和多基因风险评分来建模结肠直肠癌风险.
- 定义了不同结肠镜检查结果的10年绝对癌症风险,以确定监测值.
主要成果:
- 一种包括结肠镜检测结果,基线特征和多基因风险评分在内的模型实现了0.658.8的曲线下的面积.
- 在"平等风险的平等管理"框架下,28.2%的没有腺瘤的个体和42.7%的1-2个非晚期腺瘤被确定为高风险.
- 很大一部分在10年内患上癌症的人 (48.3-52.4%) 将被归类为高风险,监测间隔较短.
结论:
- 一个个性化,基于风险的模型可以识别患结直肠癌风险较高的个体,即使没有或只有少数腺瘤.
- 这种模式有可能优化监控策略,导致更早的检测和潜在的改善结果.
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