Cleveland Clinic develops colorectal cancer screening tool

Researchers at Cleveland Clinic have developed a new online tool that allows physicians to quickly predict the risk of colorectal cancer in individuals. Outlined in a new study in the Journal of the American Board of Family Medicine, the tool, called Colorectal Cancer Predicted Risk Online (CRC-PRO), is designed to help patients and physicians decide when screening for colorectal cancer is appropriate, according to an announcement from Cleveland Clinic.

The researchers, led by Brian Wells, Ph.D., of the Department of Quantitative Health Sciences in Cleveland Clinic's Lerner Research Institute, analyzed data on over 180,000 patients from a study conducted at the University of Hawaii. For more than 11 years, patients were followed up with to see which factors were most highly associated with developing colorectal cancer.

"Creating a risk calculator that includes multiple risk factors offers clinicians a means to more accurately predict risk than the simple age-based cutoffs currently used in clinical practice," Wells said in the announcement. "Clinicians could decide to screen high-risk patients earlier than age 50, while delaying or foregoing screening in low-risk individuals."

The final model for men in the study contained age, ethnicity, years of smoking, alcohol consumption, body mass index (BMI), education, family history of colon cancer, red meat intake, vitamin intake, history of diabetes and hours of exercise per day. For women, factors included many of the same things, but also education level, regular use of non-steroid drugs and use of estrogen.

"The development of risk prediction calculators like the CRC-PRO is vital for improving medical decision-making," Michael Kattan, Ph.D., Chair of the Department of Quantitative Health Sciences in Cleveland Clinic's Lerner Research Institute, said in the announcement. "Tools like this represent another step toward personalized medicine that will ultimately improve efficiency, outcomes and patient care."

The study authors concluded that the calculator is accurate, user friendly and internally validated for use in a diverse population.

In November, the Centers for Disease Control and Prevention warned that roughly one out of every three adults between the ages of 50 and 75 years old is not getting screened for colorectal cancer (CRC) as recommended.

In its November Vital Signs report, the CDC estimated that 23 million adults between 50 and 75 have never been tested, and that those least likely to get tested are Hispanics, those ages 50 to 64, American Indian or Alaska natives, those who don't live in a city, and people with lower education and income. What is particularly interesting is that two out of three adults who haven't been tested for colorectal cancer have regular doctors and are covered by insurance that could pay for the tests.

To learn more:
- read the study in the American Board of Family Medicine
- read the announcement

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