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Lung Cancer Risk Prediction Model Incorporating Lung Function: Development and Validation in the UK Biobank Prospective Cohort Study
- Source :
- Journal of Clinical Oncology. 35:861-869
- Publication Year :
- 2017
- Publisher :
- American Society of Clinical Oncology (ASCO), 2017.
-
Abstract
- Purpose Several lung cancer risk prediction models have been developed, but none to date have assessed the predictive ability of lung function in a population-based cohort. We sought to develop and internally validate a model incorporating lung function using data from the UK Biobank prospective cohort study. Methods This analysis included 502,321 participants without a previous diagnosis of lung cancer, predominantly between 40 and 70 years of age. We used flexible parametric survival models to estimate the 2-year probability of lung cancer, accounting for the competing risk of death. Models included predictors previously shown to be associated with lung cancer risk, including sex, variables related to smoking history and nicotine addiction, medical history, family history of lung cancer, and lung function (forced expiratory volume in 1 second [FEV1]). Results During accumulated follow-up of 1,469,518 person-years, there were 738 lung cancer diagnoses. A model incorporating all predictors had excellent discrimination (concordance (c)-statistic [95% CI] = 0.85 [0.82 to 0.87]). Internal validation suggested that the model will discriminate well when applied to new data (optimism-corrected c-statistic = 0.84). The full model, including FEV1, also had modestly superior discriminatory power than one that was designed solely on the basis of questionnaire variables (c-statistic = 0.84 [0.82 to 0.86]; optimism-corrected c-statistic = 0.83; pFEV1 = 3.4 × 10−13). The full model had better discrimination than standard lung cancer screening eligibility criteria (c-statistic = 0.66 [0.64 to 0.69]). Conclusion A risk prediction model that includes lung function has strong predictive ability, which could improve eligibility criteria for lung cancer screening programs.
- Subjects :
- Male
Oncology
Cancer Research
Lung Neoplasms
Kaplan-Meier Estimate
FAMILY-HISTORY
Cohort Studies
0302 clinical medicine
Forced Expiratory Volume
Prospective Studies
030212 general & internal medicine
SCREENING TRIAL
SUSCEPTIBILITY LOCUS
Prospective cohort study
Lung
education.field_of_study
WOMEN
CUMULATIVE RISK
ASSOCIATION
Middle Aged
respiratory system
030220 oncology & carcinogenesis
Cohort
Female
Risk assessment
Life Sciences & Biomedicine
SMOKERS
Cohort study
Adult
Risk
medicine.medical_specialty
Population
Risk Assessment
03 medical and health sciences
Predictive Value of Tests
Internal medicine
medicine
Humans
Oncology & Carcinogenesis
Intensive care medicine
Lung cancer
education
Aged
Proportional Hazards Models
Models, Statistical
Science & Technology
business.industry
Proportional hazards model
SMOKING-CESSATION
RESPIRATORY-DISEASE
medicine.disease
SURFACTANT PROTEIN-B
business
1112 Oncology And Carcinogenesis
Lung cancer screening
Subjects
Details
- ISSN :
- 15277755 and 0732183X
- Volume :
- 35
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Oncology
- Accession number :
- edsair.doi.dedup.....a0a55647e5d871885c4713987e7e6ce0