Risk Prediction for Renal Cell Carcinoma: Results from the European Prospective Investigation into Cancer and Nutrition (EPIC) Prospective Cohort Study.

Autor:	Singleton RK; School of Public Health, Imperial College London, London, United Kingdom., Heath AK; School of Public Health, Imperial College London, London, United Kingdom., Clasen JL; School of Public Health, Imperial College London, London, United Kingdom., Scelo G; Cancer Epidemiology Unit, University of Turin, Turin, Italy., Johansson M; International Agency for Research on Cancer, Lyon, France., Calvez-Kelm FL; International Agency for Research on Cancer, Lyon, France., Weiderpass E; International Agency for Research on Cancer, Lyon, France., Liedberg F; Institution of Translational Medicine, Lund University, Malmö, Sweden., Ljungberg B; Department of Surgical and Perioperative Sciences, Urology and Andrology, Umeå University, Umea, Sweden., Harbs J; Department of Radiation Sciences, Umeå University, Umea, Sweden., Olsen A; Danish Cancer Society Research Center, Copenhagen, Denmark.; Department of Public Health, University of Århus, Århus, Denmark., Tjønneland A; Danish Cancer Society Research Center, Copenhagen, Denmark.; Department of Public Health, University of Copenhagen, Copenhagen, Denmark., Dahm CC; Department of Public Health, Aarhus University, Denmark., Kaaks R; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Fortner RT; Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany., Panico S; Department of Clinical and Surgical Medicine, Federico II University, Naples, Italy., Tagliabue G; Lombardy Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori di Milano, Milan, Italy., Masala G; Cancer Risk Factors and Life-Style Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network-ISPRO, Florence, Italy., Tumino R; Cancer Registry and Histopathology Department, Provincial Health Authority (ASP 7), Ragusa, Italy., Ricceri F; Department of Clinical and Biological Sciences, University of Turin, Orbassano (TO), Italy.; Unit of Epidemiology Regional Health Service ASL TO3, Grugliasco (TO), Italy., Gram IT; Faculty of Health Sciences, Department of Community Medicine, University of Tromsø, The Arctic University of Norway, Tromsø, Norway., Santiuste C; Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain.; CIBER Epidemiología y Salud Pública (CIBERESP), Spain., Bonet C; Unit of Nutrition, Environment, and Cancer, Catalan Institute of Oncology, Barcelona, Spain., Rodriguez-Barranco M; Escuela Andaluza de Salud Pública (EASP), Granada, Madrid, Spain.; Instituto de Investigación Biosanitaria ibs.GRANADA, Granada, Spain.; Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Madrid, Spain., Schulze MB; Department of Molecular Epidemiology, German Institute of Human Nutrition Potsdam-Rehbruecke (DifE), Potsdam, Germany.; Institute of Nutrition Science, University of Potsdam, Nuthetal, Germany., Bergmann MM; Department of Epidemiology, German Institute of Human Nutrition Potsdam-Rehbrücke (DifE), Potsdam, Germany., Travis RC; Nuffield Department of Population Health, University of Oxford, Oxford, United Kingdom., Tzoulaki I; School of Public Health, Imperial College London, London, United Kingdom.; MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom.; University of Ioannina Medical School, Ioannina, Greece., Riboli E; School of Public Health, Imperial College London, London, United Kingdom., Muller DC; School of Public Health, Imperial College London, London, United Kingdom. david.muller@imperial.ac.uk.
Jazyk:	angličtina
Zdroj:	Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology [Cancer Epidemiol Biomarkers Prev] 2021 Mar; Vol. 30 (3), pp. 507-512. Date of Electronic Publication: 2020 Dec 17.
DOI:	10.1158/1055-9965.EPI-20-1438
Abstrakt:	Background: Early detection of renal cell carcinoma (RCC) has the potential to improve disease outcomes. No screening program for sporadic RCC is in place. Given relatively low incidence, screening would need to focus on people at high risk of clinically meaningful disease so as to limit overdiagnosis and screen-detected false positives. Methods: Among 192,172 participants from the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort (including 588 incident RCC cases), we evaluated a published RCC risk prediction model (including age, sex, BMI, and smoking status) in terms of discrimination (C-statistic) and calibration (observed probability as a function of predicted probability). We used a flexible parametric survival model to develop an expanded model including age, sex, BMI, and smoking status, with the addition of self-reported history of hypertension and measured blood pressure. Results: The previously published model yielded well-calibrated probabilities and good discrimination (C-statistic [95% CI]: 0.699 [0.679-0.721]). Our model had slightly improved discrimination (0.714 [0.694-0.735], bootstrap optimism-corrected C-statistic: 0.709). Despite this good performance, predicted risk was low for the vast majority of participants, with 70% of participants having 10-year risk less than 0.0025. Conclusions: Although the models performed well for the prediction of incident RCC, they are currently insufficiently powerful to identify individuals at substantial risk of RCC in a general population. Impact: Despite the promising performance of the EPIC RCC risk prediction model, further development of the model, possibly including biomarkers of risk, is required to enable risk stratification of RCC. (©2020 American Association for Cancer Research.)
Databáze:	MEDLINE
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