Tool Provides Quick, Accurate Estimate of Patient’s Risk; Improves Upon Existing Guidelines; Adds Gender, Race and Family History as Calculable Risk Factors
January 3, 2014
Researchers at Cleveland Clinic have developed a new tool called CRC-PRO that allows physicians to quickly and accurately predict an individual’s risk of colorectal cancer, as published in the current edition of the Journal of the American Board of Family Medicine.
CRC-PRO, or Colorectal Cancer Predicted Risk Online, is designed to help both patients and physicians determine when screening for colorectal cancer is appropriate. Current guidelines recommend patients are screened at the age of 50. However, with this new tool, physicians will be better able to identify who is truly at risk and when screenings for patients are necessary.
To develop the calculator, the researchers – led by Brian Wells, M.D., 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 longitudinal study conducted at the University of Hawaii. Patients were followed for up to 11.5 years to determine which factors were highly associated with the development of 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,” said Dr. Wells. “Clinicians could decide to screen high-risk patients earlier than age 50, while delaying or foregoing screening in low-risk individuals. ”
Wells and his colleagues hope that their new, user-friendly calculator will help improve the efficiency of colorectal cancer screenings. They also believe prediction tools like this can help lower healthcare costs by cutting down on unnecessary testing.
The Multiethnic Cohort Study comprised a diverse ethnic population. Previously, most research in this area has been performed predominately in Caucasians. Because cancer risk differs drastically in different racial groups, the researchers felt that an ethnically diverse population would more accurately reflect true cancer risk.
“The development of risk prediction calculators like the CRC-PRO is vital for improving medical decision-making,” said Michael Kattan, Ph.D., Chair of the Department of Quantitative Health Sciences in Cleveland Clinic’s Lerner Research Institute. “Tools like this represent another step toward personalized medicine that will ultimately improve efficiency, outcomes and patient care.”
Kattan and his research team are involved in the creation of numerous risk prediction tools, including heart disease and cancers of the breast, prostate and thyroid, that are available at http://rcalc.ccf.org. He is currently working on software that will integrate these tools for automatic calculation in the Electronic Health Record to make this process easier for physicians.
About Cleveland Clinic
Cleveland Clinic is a nonprofit multispecialty academic medical center that integrates clinical and hospital care with research and education. Located in Cleveland, Ohio, it was founded in 1921 by four renowned physicians with a vision of providing outstanding patient care based upon the principles of cooperation, compassion and innovation. Cleveland Clinic has pioneered many medical breakthroughs, including coronary artery bypass surgery and the first face transplant in the United States. U.S.News & World Report consistently names Cleveland Clinic as one of the nation’s best hospitals in its annual “America’s Best Hospitals” survey. More than 3,000 full-time salaried physicians and researchers and 11,000 nurses represent 120 medical specialties and subspecialties. The Cleveland Clinic health system includes a main campus near downtown Cleveland, more than 75 Northern Ohio outpatient locations, including 16 full-service Family Health Centers, Cleveland Clinic Florida, the Lou Ruvo Center for Brain Health in Las Vegas, Cleveland Clinic Canada, and, currently under construction, Cleveland Clinic Abu Dhabi. In 2012, there were 5.1 million outpatient visits throughout the Cleveland Clinic health system and 157,000 hospital admissions. Patients came for treatment from every state and from more than 130 countries. Visit us at www.clevelandclinic.org. Follow us at www.twitter.com/ClevelandClinic.
About the Lerner Research Institute
The Lerner Research Institute (LRI) is home to laboratory, translational and clinical research at Cleveland Clinic. Its three-part mission is: to promote human health by investigating the causes of disease and discovering new approaches to prevention and treatments, to train the next generation of biomedical researchers and to foster collaborations with clinical care providers. LRI’s total annual research expenditure was $255 million in 2012 (nearly $110 million in federal funding). With more than 700,000 square feet of lab, office, and core services space, LRI is home to more than 2,000 people working in disease-focused research programs. In 2012, LRI researchers published over 600 articles in high-impact biomedical journals (top 10 percent) and generated 83 invention disclosures, 10 new licenses and 35 patents. LRI faculty oversee curriculum and teach courses in the Cleveland Clinic Lerner College of Medicine (CCLCM) of Case Western Reserve University and participate in doctoral programs, including the Molecular Medicine PhD Program, supported in part by the Howard Hughes Medical Institute.
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