Title |
An epidemiological model for prediction of endometrial cancer risk in Europe
|
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Published in |
European Journal of Epidemiology, May 2015
|
DOI | 10.1007/s10654-015-0030-9 |
Pubmed ID | |
Authors |
Anika Hüsing, Laure Dossus, Pietro Ferrari, Anne Tjønneland, Louise Hansen, Guy Fagherazzi, Laura Baglietto, Helena Schock, Jenny Chang-Claude, Heiner Boeing, Annika Steffen, Antonia Trichopoulou, Christina Bamia, Michalis Katsoulis, Vittorio Krogh, Domenico Palli, Salvatore Panico, N. Charlotte Onland-Moret, Petra H. Peeters, H. Bas Bueno-de-Mesquita, Elisabete Weiderpass, Inger T. Gram, Eva Ardanaz, Mireia Obón-Santacana, Carmen Navarro, Emilio Sánchez-Cantalejo, Nerea Etxezarreta, Naomi E. Allen, Kay Tee Khaw, Nick Wareham, Sabina Rinaldi, Isabelle Romieu, Melissa A. Merritt, Marc Gunter, Elio Riboli, Rudolf Kaaks |
Abstract |
Endometrial cancer (EC) is the fourth most frequent cancer in women in Europe, and as its incidence is increasing, prevention strategies gain further pertinence. Risk prediction models can be a useful tool for identifying women likely to benefit from targeted prevention measures. On the basis of data from 201,811 women (mostly aged 30-65 years) including 855 incident EC cases from eight countries in the European Prospective Investigation into Cancer and Nutrition cohort, a model to predict EC was developed. A step-wise model selection process was used to select confirmed predictive epidemiologic risk factors. Piece-wise constant hazard rates in 5-year age-intervals were estimated in a cause-specific competing risks model, five-fold-cross-validation was applied for internal validation. Risk factors included in the risk prediction model were body-mass index (BMI), menopausal status, age at menarche and at menopause, oral contraceptive use, overall and by different BMI categories and overall duration of use, parity, age at first full-term pregnancy, duration of menopausal hormone therapy and smoking status (specific for pre, peri- and post-menopausal women). These variables improved the discriminating capacity to predict risk over 5 years from 71 % for a model based on age alone to 77 % (overall C statistic), and the model was well-calibrated (ratio of expected to observed cases = 0.99). Our model could be used for the identification of women at increased risk of EC in Western Europe. To achieve an EC-risk model with general validity, a large-scale cohort-consortium approach would be needed to assess and adjust for population variation. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 3 | 60% |
Unknown | 2 | 40% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 5 | 100% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
Slovenia | 1 | <1% |
Unknown | 110 | 99% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Researcher | 18 | 16% |
Student > Ph. D. Student | 14 | 13% |
Student > Bachelor | 14 | 13% |
Student > Master | 12 | 11% |
Other | 6 | 5% |
Other | 17 | 15% |
Unknown | 30 | 27% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 37 | 33% |
Nursing and Health Professions | 12 | 11% |
Biochemistry, Genetics and Molecular Biology | 6 | 5% |
Agricultural and Biological Sciences | 5 | 5% |
Pharmacology, Toxicology and Pharmaceutical Science | 3 | 3% |
Other | 10 | 9% |
Unknown | 38 | 34% |