한빛사논문
- 조회430
Jae Jeong Yang PhD 1,2,3, Wanqing Wen MD 1, Hana Zahed MS 4, Wei Zheng PhD 1, Qing Lan PhD 5, Sarah K. Abe PhD 6, Md. Shafiur Rahman PhD 6,7, Md. Rashedul Islam PhD 6,8, Eiko Saito PhD 9, Prakash C. Gupta PhD 10, Akiko Tamakoshi PhD 11, Woon-Puay Koh PhD 12,13, Yu-Tang Gao MD 14, Ritsu Sakata PhD 15, Ichiro Tsuji PhD 16, Reza Malekzadeh PhD 17, Yumi Sugawara PhD 16, Jeongseon Kim PhD 18, Hidemi Ito PhD 19,20, Chisato Nagata PhD 21, San-Lin You PhD 22, Sue K. Park PhD 23, Jian-Min Yuan PhD 24,25, Myung-Hee Shin PhD 26, Sun-Seog Kweon PhD 27, Sang-Wook Yi PhD 28, Mangesh S. Pednekar PhD 10, Takashi Kimura PhD 11, Hui Cai PhD 1, Yukai Lu PhD 16, Arash Etemadi PhD 29, Seiki Kanemura PhD 16, Keiko Wada PhD 21, Chien-Jen Chen ScD 30, Aesun Shin PhD 23,31, Renwei Wang MD 24, Yoon-Ok Ahn PhD 23, Min-Ho Shin PhD 27, Heechoul Ohrr PhD 32, Mahdi Sheikh PhD 4, Batel Blechter PhD 5, Habibul Ahsan MD 33, Paolo Boffetta MD 34,35, Kee Seng Chia MD 36, Keitaro Matsuo PhD 37,38, You-Lin Qiao PhD 39, Nathaniel Rothman PhD 5, Manami Inoue PhD 6, Daehee Kang PhD 23,31, Hilary A. Robbins PhD 4, Xiao-Ou Shu PhD 1
1Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA
2Department of Surgery, University of Florida College of Medicine, Gainesville, Florida, USA
3University of Florida Health Cancer Center, Gainesville, Florida, USA
4International Agency for Research on Cancer, Lyon, France
5Division of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, Maryland, USA
6Division of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan
7Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
8Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan
9Institute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan
10Healis - Sekhsaria Institute for Public Health Mahaleb, Navi Mumbai
11Department of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan
12Healthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
13Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A*STAR), Singapore, Singapore
14Department of Epidemiology, Shanghai Cancer Institute Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
15Radiation Effects Research Foundation, Hiroshima, Japan
16Tohoku University Graduate School of Medicine, Miyagi Prefecture, Japan
17Digestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran
18Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea
19Division of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan
20Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
21Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan
22School of Medicine & Big Data Research Center, Fu Jen Catholic University, New Taipei City, Taiwan
23Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea
24Division of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
25Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
26Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
27Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea
28Department of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea
29Metabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Healsh, Bethesda, Maryland, USA
30Genomics Research Center, Academia Sinica, Taipei City, Taiwan
31Cancer Research Institute, Seoul National University, Seoul, Republic of Korea
32Department of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea
33Department of Public Health Sciences, University of Chicago, Illinois, USA
34Stony Brook Cancer Center, Stony Brook University, Stony Brook, New York, USA
35Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
36Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore
37Division Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
38Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
39School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
Corresponding author: Xiao-Ou Shu, MD, PhD
Abstract
Objectives: Although lung cancer prediction models are widely used to support risk-based screening, their performance outside Western populations remains uncertain. This study aims to evaluate the performance of 11 existing risk prediction models in multiple Asian populations and to re-fit prediction models for Asians.
Methods: In a pooled analysis of 186,458 Asian ever-smokers from 19 prospective cohorts, we assessed calibration (expected to observed ratios, E/O) and discrimination (area under the receiver operating characteristic curves, AUCs) for each model. In addition, we developed the 'Shanghai models' to better refine risk models for Asians based on two well-characterized population-based prospective cohorts and externally validated them in other Asian cohorts.
Results: Among 11 models, the Lung Cancer Death Risk Assessment Tool yielded the highest AUC (AUC [95% CI]=0.71 [0.67-0.74] for lung cancer death and 0.69 [0.67-0.72] for lung cancer incidence), and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Model showed good calibration overall (E/O [95% CI]=1.06 [0.90-1.25]). However, these models substantially underestimated lung cancer risk among Asians who reported less than 10 smoking pack-years or stopped smoking ≥20 years ago. The Shanghai models showed marginal improvement overall in discrimination (AUC [95% CI]=0.72 [0.69-0.74] for lung cancer death and 0.70 [0.67-0.72] for lung cancer incidence) but consistently outperformed the selected Western models among low-intensity smokers and long-term quitters.
Conclusions: The Shanghai models had comparable performance overall to the best existing models, but they improved much in predicting the lung cancer risk of low-intensity smokers and long-term quitters in Asia.
논문정보
- Research article
- 2023년 11월 (BRIC 등록일 2023-11-14)
- 국내+국외 연구진
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