A study used a risk-advancement period approach incorporating sex and polygenic risk score (PRS) to determine the appropriate starting ages for colorectal cancer (CRC) screening. The study found significant differences in the recommended screening age for CRC between men and women.
Key Findings:
Increased Risk in Men: Men exhibited a 1.6-fold increased risk for CRC occurrence compared to women and reached an equivalent risk for CRC approximately 6 years earlier.
Impact of Polygenic Risk Score: The study utilized PRS based on 139 of 140 previously identified CRC-related risk variants. Individuals in the highest PRS decile had double the risk for CRC occurrence and reached equivalent levels of risk 10 years earlier than those in the middle decile.
Variation in Screening Ages: Based on CRC mortality as a benchmark, the study suggested risk-adapted starting ages for screening ranging from 50 to 67 years for women and 45 to 62 years for men. This indicates a potential 24-year variation in screening ages between men with high genetic risk scores and women with low genetic risk scores.
The study, led by Hermann Brenner, MD, MPH, from the German Cancer Research Center, analyzed data from 242,779 participants in the UK Biobank. The findings highlight the importance of personalized screening recommendations based on individual risk factors, including genetic predisposition. Further research is needed for the refinement and implementation of risk-adapted recommendations for CRC screening in routine practice. Brenner emphasizes the potential of this approach to translate epidemiological study results into personalized screening guidelines.