Response to Wernly, Datz, and Wernly.
Response to Wernly, Datz, and Wernly.
复制标题
对 Wernly、Datz 和 Wernly 的回应。
DOI：
10.1093/jnci/djab233
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发表时间：
2022
期刊：
影响因子：
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通讯作者：
Song,Mingyang
中科院分区：
文献类型：
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作者：
Wang,Kai;Song,Mingyang
我们很欣赏Werechty等人的评论。(1)在我们的队列研究中，我们根据个体的风险状况报告了结肠镜筛查的益处。首先，我们同意构成结直肠癌风险特征的8个风险因素的效应大小可能不同，使用加权评分可以改善风险分层。然而，我们选择了等权重方法来简化1）对我们发现的解释（即，评分增加1个单位代表1个风险因素的改善）; 2）未来潜在临床翻译的公共卫生信息。此外，类似的方法已被广泛用于其他团体在先前的研究（2，3）。其次，我们同意8个风险因素中的一些可能具有生物学相互作用。然而，我们研究的主要目标是测试使用风险因素数据改善癌症预防的临床转化潜力，而不是最好地捕捉这些因素的生物学效应。最后，关于对性别的解释，因为我们的两个队列是性别特异性的（护士健康研究仅包括女性，卫生专业人员随访研究仅包括男性），我们所有的分析都是按队列分层的，我们还在原始研究的补充数据中分别显示了女性和男性的主要发现（见补充材料，在线提供）。我们对高身材的定义也是性别特异性的。尽管如此，我们还是要感谢Wernly等人。(1)他们的评论。
We appreciate the comments from Wernly et al.(1) on our cohort study in which we reported the benefit of colonoscopy screening according to individuals’ risk profiles. First, we agree that the effect size of the 8 risk factors constituting the risk profile in relation to colorectal cancer may vary and that using weighted scores can improve risk stratification. However, we chose the equal weighing approach to simplify 1) the interpretation of our findings (ie, 1-unit increase in the score represents an improvement in 1 risk factor); and 2) the public health message for potential clinical translation in the future. Also, a similar approach has been widely used by other groups in prior studies (2, 3). Second, we agree that some of the 8 risk factors may have biological interactions. However, the primary goal of our study is to test the clinical translational potential of using the risk factor data to improve cancer prevention rather than to best capture the biological effect of these factors. Finally, regarding the comment on accounting for sex, because our 2 cohorts are sex-specific (the Nurses’ Health Study includes women only and the Health Professionals Follow-up Study includes men only), all our analyses were stratified by cohort, and we additionally showed our main finding for women and men separately in the supplementary data of our original study (see the Supplementary Materials, available online). Our definition of tall stature is also sex specific. Nonetheless, we would like to thank Wernly et al.(1) for their comments.