Prediction of individuals at high absolute risk of esophageal squamous cell carcinoma
Wang, Qiao-Li LU
; Lagergren, Jesper
and Xie, Shao-Hua
(2019)
In Gastrointestinal Endoscopy
89(4).
p.2-732
- Abstract
BACKGROUND AND AIMS: This study aimed to develop a prediction model for identifying individuals at high absolute risk of esophageal squamous cell carcinoma (ESCC) for endoscopic screening at a curable stage based on readily identifiable risk factors.
METHODS: This was a nationwide Swedish population-based, case-control study, including 167 new cases of ESCC and 820 randomly selected control participants. Odds ratios with 95% confidence intervals (CI) were assessed by using multivariable unconditional logistic regression. The discriminative accuracy of the model was assessed by the area under the receiver operating characteristic curve (AUC) with leave-1-out cross validation. Models for projecting individuals' absolute 5-year risk... (More)
BACKGROUND AND AIMS: This study aimed to develop a prediction model for identifying individuals at high absolute risk of esophageal squamous cell carcinoma (ESCC) for endoscopic screening at a curable stage based on readily identifiable risk factors.
METHODS: This was a nationwide Swedish population-based, case-control study, including 167 new cases of ESCC and 820 randomly selected control participants. Odds ratios with 95% confidence intervals (CI) were assessed by using multivariable unconditional logistic regression. The discriminative accuracy of the model was assessed by the area under the receiver operating characteristic curve (AUC) with leave-1-out cross validation. Models for projecting individuals' absolute 5-year risk of ESCC were developed by incorporating the age-specific and sex-specific incidence rates and competing risk of death from other causes.
RESULTS: A model including the risk factors age, sex, tobacco smoking, alcohol overconsumption, education, duration of living with a partner, and place of residence during childhood generated an AUC of 0.81 (95% CI, 0.77-0.84). A model based only on age, sex, tobacco smoking, and alcohol overconsumption obtained a similar AUC (0.79; 95% CI, 0.75-0.82). A 5-year follow-up of 355 men aged 70 to 74 years with over 35 years' smoking and alcohol overconsumption history is needed to detect 1 ESCC case. The estimated individuals' absolute 5-year risk of ESCC varied according to the combinations of risk factors.
CONCLUSION: This easy-to-use risk prediction model showed a good discriminative accuracy and had the potential to identify individuals at high absolute risk of ESCC who might benefit from tailored endoscopic screening and surveillance.
(Less)
- author
- Wang, Qiao-Li
LU
; Lagergren, Jesper
and Xie, Shao-Hua
- publishing date
- 2019-04
- type
- Contribution to journal
- publication status
- published
- keywords
- Age Factors, Aged, Alcoholism/epidemiology, Area Under Curve, Case-Control Studies, Early Detection of Cancer, Educational Status, Endoscopy, Gastrointestinal, Esophageal Squamous Cell Carcinoma/diagnostic imaging, Female, Humans, Logistic Models, Male, Middle Aged, ROC Curve, Risk Assessment/methods, Risk Factors, Sex Factors, Sweden/epidemiology, Tobacco Smoking
- in
- Gastrointestinal Endoscopy
- volume
- 89
- issue
- 4
- pages
- 2 - 732
- publisher
- Elsevier
- external identifiers
-
- scopus:85060102612
- pmid:30616974
- ISSN
- 1097-6779
- DOI
- 10.1016/j.gie.2018.10.025
- language
- English
- LU publication?
- no
- additional info
- Copyright © 2019 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.
- id
- a23712f5-26e2-4590-a3ef-d99c0a7bda0a
- date added to LUP
- 2025-05-12 17:00:36
- date last changed
- 2025-05-27 06:16:32
@article{a23712f5-26e2-4590-a3ef-d99c0a7bda0a,
abstract = {{<p>BACKGROUND AND AIMS: This study aimed to develop a prediction model for identifying individuals at high absolute risk of esophageal squamous cell carcinoma (ESCC) for endoscopic screening at a curable stage based on readily identifiable risk factors.</p><p>METHODS: This was a nationwide Swedish population-based, case-control study, including 167 new cases of ESCC and 820 randomly selected control participants. Odds ratios with 95% confidence intervals (CI) were assessed by using multivariable unconditional logistic regression. The discriminative accuracy of the model was assessed by the area under the receiver operating characteristic curve (AUC) with leave-1-out cross validation. Models for projecting individuals' absolute 5-year risk of ESCC were developed by incorporating the age-specific and sex-specific incidence rates and competing risk of death from other causes.</p><p>RESULTS: A model including the risk factors age, sex, tobacco smoking, alcohol overconsumption, education, duration of living with a partner, and place of residence during childhood generated an AUC of 0.81 (95% CI, 0.77-0.84). A model based only on age, sex, tobacco smoking, and alcohol overconsumption obtained a similar AUC (0.79; 95% CI, 0.75-0.82). A 5-year follow-up of 355 men aged 70 to 74 years with over 35 years' smoking and alcohol overconsumption history is needed to detect 1 ESCC case. The estimated individuals' absolute 5-year risk of ESCC varied according to the combinations of risk factors.</p><p>CONCLUSION: This easy-to-use risk prediction model showed a good discriminative accuracy and had the potential to identify individuals at high absolute risk of ESCC who might benefit from tailored endoscopic screening and surveillance.</p>}},
author = {{Wang, Qiao-Li and Lagergren, Jesper and Xie, Shao-Hua}},
issn = {{1097-6779}},
keywords = {{Age Factors; Aged; Alcoholism/epidemiology; Area Under Curve; Case-Control Studies; Early Detection of Cancer; Educational Status; Endoscopy, Gastrointestinal; Esophageal Squamous Cell Carcinoma/diagnostic imaging; Female; Humans; Logistic Models; Male; Middle Aged; ROC Curve; Risk Assessment/methods; Risk Factors; Sex Factors; Sweden/epidemiology; Tobacco Smoking}},
language = {{eng}},
number = {{4}},
pages = {{2--732}},
publisher = {{Elsevier}},
series = {{Gastrointestinal Endoscopy}},
title = {{Prediction of individuals at high absolute risk of esophageal squamous cell carcinoma}},
url = {{http://dx.doi.org/10.1016/j.gie.2018.10.025}},
doi = {{10.1016/j.gie.2018.10.025}},
volume = {{89}},
year = {{2019}},
}