{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:27:43Z","timestamp":1792787263489,"version":"4.5.0"},"reference-count":52,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2024,1,4]],"date-time":"2024-01-04T00:00:00Z","timestamp":1704326400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Research Foundation of Flanders","award":["G0C2520N"],"award-info":[{"award-number":["G0C2520N"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJNPH"],"accepted":{"date-parts":[[2023,10,10]]},"published-print":{"date-parts":[[2024,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Colorectal cancer (CRC) is the second most prevalent cancer in Europe, with one-fifth of cases attributable to unhealthy lifestyles. Risk prediction models for quantifying CRC risk and identifying high-risk groups have been developed or validated across European populations, some considering lifestyle as a predictor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To identify lifestyle predictors considered in existing risk prediction models applicable for European populations and characterise their corresponding parameter values for an improved understanding of their relative contribution to prediction across different models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic review was conducted in PubMed and Web of Science from January 2000 to August 2021. Risk prediction models were included if (1) developed and\/or validated in an adult asymptomatic European population, (2) based on non-invasively measured predictors and (3) reported mean estimates and uncertainty for predictors included. To facilitate comparison, model-specific lifestyle predictors were visualised using forest plots.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 21 risk prediction models for CRC (reported in 16 studies) were eligible, of which 11 were validated in a European adult population but developed elsewhere, mostly USA. All models but two reported at least one lifestyle factor as predictor. Of the lifestyle factors, the most common predictors were body mass index (BMI) and smoking (each present in 13 models), followed by alcohol (11), and physical activity (7), while diet-related factors were less considered with the most commonly present meat (9), vegetables (5) or dairy (2). The independent predictive contribution was generally greater when they were collected with greater detail, although a noticeable variation in effect size estimates for BMI, smoking and alcohol.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Early identification of high-risk groups based on lifestyle data offers the potential to encourage participation in lifestyle change and screening programmes, hence reduce CRC burden. We propose the commonly shared lifestyle predictors to be further used in public health prediction modelling for improved uptake of the model.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjnph-2022-000554","type":"journal-article","created":{"date-parts":[[2024,1,10]],"date-time":"2024-01-10T00:36:27Z","timestamp":1704846987000},"page":"183-190","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":8,"title":["Lifestyle predictors of colorectal cancer in European populations: a systematic review"],"prefix":"10.1136","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4957-4235","authenticated-orcid":false,"given":"Elly","family":"Mertens","sequence":"first","affiliation":[{"name":"Unit of Non-Comunicable Diseases, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Keuchkarian","sequence":"additional","affiliation":[{"name":"Unit of Non-Comunicable Diseases, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium"},{"name":"Faculty of Bioscience Engineering, Ghent University, Gent, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Salve","family":"Vasquez","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefanie","family":"Vandevijvere","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jos\u00e9 L","family":"Pe\u00f1alvo","sequence":"additional","affiliation":[{"name":"Unit of Non-Comunicable Diseases, Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium"},{"name":"Global Health Institute, University of Antwerp, Wilrijk, Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,1,4]]},"reference":[{"key":"2026010704504236000_7.1.183.1","unstructured":"Ferlay J , Ervik M , Lam F , et al . Global cancer observatory: cancer today Lyon. France International Agency for Research on Cancer; 2020. Available: https:\/\/gco.iarc.fr\/today [Accessed 06 Jan 2022]."},{"key":"2026010704504236000_7.1.183.2","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(21)00199-6"},{"key":"2026010704504236000_7.1.183.3","unstructured":"European Commission . Cancer screening in the European Union: scientific advice on improving cancer screening across the EU. Brussels: Group of Chief Scientific Advisors, 2022: 48."},{"key":"2026010704504236000_7.1.183.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-014-0168-4","article-title":"Combined impact of healthy lifestyle factors on colorectal cancer: a large European cohort study","volume":"12","author":"Aleksandrova","year":"2014","journal-title":"BMC Med"},{"key":"2026010704504236000_7.1.183.5","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-11-0771"},{"key":"2026010704504236000_7.1.183.6","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2014.01.042"},{"key":"2026010704504236000_7.1.183.7","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-15-0274"},{"key":"2026010704504236000_7.1.183.8","doi-asserted-by":"crossref","DOI":"10.1186\/s12876-016-0475-7","article-title":"Risk prediction models for colorectal cancer in people with symptoms: a systematic review","volume":"16","author":"Williams","year":"2016","journal-title":"BMC Gastroenterol"},{"key":"2026010704504236000_7.1.183.9","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-19-0059"},{"key":"2026010704504236000_7.1.183.10","doi-asserted-by":"crossref","DOI":"10.1186\/s12885-021-09143-2","article-title":"Polygenic risk prediction models for colorectal cancer: a systematic review","volume":"22","author":"Sassano","year":"2022","journal-title":"BMC Cancer"},{"key":"2026010704504236000_7.1.183.11","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-17-0141"},{"key":"2026010704504236000_7.1.183.12","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1016\/j.gene.2018.06.035","article-title":"Evaluating the effect of multiple genetic risk score models on colorectal cancer risk prediction","volume":"673","author":"Xin","year":"2018","journal-title":"Gene"},{"key":"2026010704504236000_7.1.183.13","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1053\/j.gastro.2018.03.030","article-title":"Genetic risk score is associated with prevalence of advanced neoplasms in a colorectal cancer screening population","volume":"155","author":"Weigl","year":"2018","journal-title":"Gastroenterology"},{"key":"2026010704504236000_7.1.183.14","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2018.296103"},{"key":"2026010704504236000_7.1.183.15","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2015-310912"},{"key":"2026010704504236000_7.1.183.16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2021.03.001"},{"key":"2026010704504236000_7.1.183.17","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001744","article-title":"Critical appraisal and data extraction for systematic reviews of prediction modelling studies: the CHARMS checklist","volume":"11","author":"Moons","year":"2014","journal-title":"PLOS Med"},{"key":"2026010704504236000_7.1.183.18","doi-asserted-by":"crossref","DOI":"10.7326\/M18-1377","article-title":"PROBAST: a tool to assess risk of bias and applicability of prediction model studies: explanation and elaboration","volume":"170","author":"Moons","year":"2019","journal-title":"Ann Intern Med"},{"key":"2026010704504236000_7.1.183.19","unstructured":"World Cancer Research Fund\/American Institute for Cancer Research . Diet, nutrition, physical activity and cancer: a global perspective. Continuous update project expert report; 2018."},{"key":"2026010704504236000_7.1.183.20","first-page":"2648","article-title":"Use of colonoscopy as a primary screening test for colorectal cancer in average risk people","volume":"98","author":"Bet\u00e9s","year":"2003","journal-title":"Am J Gastroenterol"},{"key":"2026010704504236000_7.1.183.21","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.28007"},{"key":"2026010704504236000_7.1.183.22","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2014.06.008"},{"key":"2026010704504236000_7.1.183.23","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-304965"},{"key":"2026010704504236000_7.1.183.24","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2013-305013"},{"key":"2026010704504236000_7.1.183.25","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2013.08.042"},{"key":"2026010704504236000_7.1.183.26","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-18-0400"},{"key":"2026010704504236000_7.1.183.27","doi-asserted-by":"crossref","DOI":"10.1186\/s12916-020-01826-0","article-title":"Development and validation of a lifestyle-based model for colorectal cancer risk prediction: the lifecrc score","volume":"19","author":"Aleksandrova","year":"2021","journal-title":"BMC Med"},{"key":"2026010704504236000_7.1.183.28","doi-asserted-by":"publisher","DOI":"10.1023\/A:1008984432272"},{"key":"2026010704504236000_7.1.183.29","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2006.05.055"},{"key":"2026010704504236000_7.1.183.30","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.17.4797"},{"key":"2026010704504236000_7.1.183.31","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1016\/j.canep.2010.04.021","article-title":"10-year risk of colorectal cancer: development and validation of a prediction model in middle-aged Japanese men","volume":"34","author":"Ma","year":"2010","journal-title":"Cancer Epidemiol"},{"key":"2026010704504236000_7.1.183.32","doi-asserted-by":"publisher","DOI":"10.1097\/GIM.0b013e3182064384"},{"key":"2026010704504236000_7.1.183.33","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0088079","article-title":"Risk prediction model for colorectal cancer: national health insurance corporation study, Korea","volume":"9","author":"Shin","year":"2014","journal-title":"PLoS One"},{"key":"2026010704504236000_7.1.183.34","doi-asserted-by":"publisher","DOI":"10.1158\/1055-9965.EPI-14-0206"},{"key":"2026010704504236000_7.1.183.35","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2014.01.130040"},{"key":"2026010704504236000_7.1.183.36","doi-asserted-by":"publisher","DOI":"10.1136\/gutjnl-2017-315730"},{"key":"2026010704504236000_7.1.183.37","first-page":"1573","article-title":"Lifestyle interventions to reduce cancer risk and improve outcomes","volume":"77","author":"Demark-Wahnefried","year":"2008","journal-title":"Am Fam Physician"},{"key":"2026010704504236000_7.1.183.38","doi-asserted-by":"publisher","DOI":"10.1158\/1940-6207.CAPR-12-0385"},{"key":"2026010704504236000_7.1.183.39","doi-asserted-by":"crossref","DOI":"10.1001\/jamanetworkopen.2020.37341","article-title":"Role of diet in colorectal cancer incidence: umbrella review of meta-analyses of prospective observational studies","volume":"4","author":"Veettil","year":"2021","journal-title":"JAMA Netw Open"},{"key":"2026010704504236000_7.1.183.40","doi-asserted-by":"crossref","DOI":"10.1186\/s12982-018-0080-z","article-title":"Clarifying questions about \u201crisk factors\u201d: predictors versus explanation","volume":"15","author":"Schooling","year":"2018","journal-title":"Emerg Themes Epidemiol"},{"key":"2026010704504236000_7.1.183.41","doi-asserted-by":"crossref","first-page":"ii1","DOI":"10.1093\/ndt\/gfw459","article-title":"Prediction versus aetiology: common pitfalls and how to avoid them","volume":"32","author":"van Diepen","year":"2017","journal-title":"Nephrol Dial Transplant"},{"key":"2026010704504236000_7.1.183.42","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-021-00794-w"},{"key":"2026010704504236000_7.1.183.43","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1001\/jamapsychiatry.2019.3671","article-title":"Establishment of best practices for evidence for prediction: a review","volume":"77","author":"Poldrack","year":"2020","journal-title":"JAMA Psychiatry"},{"key":"2026010704504236000_7.1.183.44","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.b2393","article-title":"Multiple imputation for missing data in epidemiological and clinical research: potential and pitfalls","volume":"338","author":"Sterne","year":"2009","journal-title":"BMJ"},{"key":"2026010704504236000_7.1.183.45","doi-asserted-by":"publisher","DOI":"10.1373\/clinchem.2008.115345"},{"key":"2026010704504236000_7.1.183.46","doi-asserted-by":"crossref","first-page":"154","DOI":"10.1093\/ehjdh\/ztaa016","article-title":"Real-time imputation of missing predictor values in clinical practice","volume":"2","author":"Nijman","year":"2021","journal-title":"Eur Heart J Digit Health"},{"key":"2026010704504236000_7.1.183.47","doi-asserted-by":"publisher","DOI":"10.1002\/sim.8682"},{"key":"2026010704504236000_7.1.183.48","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2288-14-40","article-title":"External validation of multivariable prediction models: a systematic review of methodological conduct and reporting","volume":"14","author":"Collins","year":"2014","journal-title":"BMC Med Res Methodol"},{"key":"2026010704504236000_7.1.183.49","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2018.07.010"},{"key":"2026010704504236000_7.1.183.50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2020.12.005"},{"key":"2026010704504236000_7.1.183.51","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i6460","article-title":"A guide to systematic review and meta-analysis of prediction model performance","volume":"356","author":"Debray","year":"2017","journal-title":"BMJ"},{"key":"2026010704504236000_7.1.183.52","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: an updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"}],"container-title":["BMJ Nutrition, Prevention &amp; Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjnph-2022-000554","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T12:50:57Z","timestamp":1767790257000},"score":1,"resource":{"primary":{"URL":"https:\/\/nutrition.bmj.com\/lookup\/doi\/10.1136\/bmjnph-2022-000554"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,4]]},"references-count":52,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,6,27]]},"published-print":{"date-parts":[[2024,6]]}},"alternative-id":["10.1136\/bmjnph-2022-000554"],"URL":"https:\/\/doi.org\/10.1136\/bmjnph-2022-000554","relation":{},"ISSN":["2516-5542"],"issn-type":[{"value":"2516-5542","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,4]]}}}