Personalized Risk Assessment in Never, Light, and Heavy Smokers in a prospective cohort in Taiwan
| Autor: | Christopher Wen, Jack A. Roth, Shuanbei Wu, Sonia A. Cunningham, Maosheng Huang, Chi Pang Wen, Xifeng Wu, Jian Gu, Chwen Keng Tsao, Wong Ho Chow, Min Kwang Tsai, Xia Pu, Yuanqing Ye, Chad D. Huff, Scott M. Lippman |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Lung Neoplasms National Health Programs Cohort Studies 0302 clinical medicine Carcinoembryonic antigen Risk Factors 030212 general & internal medicine Prospective Studies Family history Prospective cohort study Lung Tomography Cancer education.field_of_study Multidisciplinary Smokers biology Lung Cancer Discriminant Analysis Middle Aged X-Ray Computed Respiratory Function Tests C-Reactive Protein 030220 oncology & carcinogenesis Area Under Curve Female alpha-Fetoproteins Risk assessment Cohort study medicine.medical_specialty Population Taiwan Risk Assessment Article 03 medical and health sciences Clinical Research Internal medicine Tobacco medicine Humans education Lung cancer Author Correction Aged Proportional Hazards Models Tobacco Smoke and Health business.industry Prevention Retrospective cohort study Bilirubin medicine.disease respiratory tract diseases Carcinoembryonic Antigen Good Health and Well Being ROC Curve Multivariate Analysis Physical therapy biology.protein business Tomography X-Ray Computed |
| Zdroj: | Scientific Reports Scientific reports, vol 6, iss 1 |
| ISSN: | 2045-2322 |
| Popis: | The objective of this study was to develop markedly improved risk prediction models for lung cancer using a prospective cohort of 395,875 participants in Taiwan. Discriminatory accuracy was measured by generation of receiver operator curves and estimation of area under the curve (AUC). In multivariate Cox regression analysis, age, gender, smoking pack-years, family history of lung cancer, personal cancer history, BMI, lung function test, and serum biomarkers such as carcinoembryonic antigen (CEA), bilirubin, alpha fetoprotein (AFP), and c-reactive protein (CRP) were identified and included in an integrative risk prediction model. The AUC in overall population was 0.851 (95% CI = 0.840–0.862), with never smokers 0.806 (95% CI = 0.790–0.819), light smokers 0.847 (95% CI = 0.824–0.871), and heavy smokers 0.732 (95% CI = 0.708–0.752). By integrating risk factors such as family history of lung cancer, CEA and AFP for light smokers, and lung function test (Maximum Mid-Expiratory Flow, MMEF25–75%), AFP and CEA for never smokers, light and never smokers with cancer risks as high as those within heavy smokers could be identified. The risk model for heavy smokers can allow us to stratify heavy smokers into subgroups with distinct risks, which, if applied to low-dose computed tomography (LDCT) screening, may greatly reduce false positives. |
| Databáze: | OpenAIRE |
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