Validation of a model of lung cancer risk prediction among smokers
Validation of a model of lung cancer risk prediction among smokers
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DOI：
10.1093/jnci/djj163
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发表时间：
2006-05-03
影响因子：
10.3
通讯作者：
Albanes, Demetrius
中科院分区：
文献类型：
--
作者：
Cronin, Kathleen A.;Gail, Mitchell H.;Albanes, Demetrius
Bach模型是通过使用胡萝卜素和视黄醇预防肺癌疗效试验的参与者来预测吸烟者患肺癌的绝对10年风险的。我们在α-生育酚，β-胡萝卜素癌症预防(ATBC)研究的安慰剂组的6239名吸烟者中评估了巴赫模型的有效性。根据Bach模型计算出预期的肺癌病例和非肺癌死亡人数，并与10年内相应事件的观察人数进行比较。我们发现，风险模型略微低估了10年内观察到的肺癌风险(预期肺癌数量/观察数量0.89，95%可信区间[CI]0.80至0.99)。模型的竞争风险部分严重低估了10年内非肺癌死亡的风险(预计非肺癌死亡人数/观察人数=0.61，95%CI=0.57至0.64)。50-54岁、55-59岁、60-和65-69岁年龄组的10年预测一致性指数分别为0.77(95%CI=0.70~0.84)、0.59(95%CI=0.53~0.65)、0.62(95%CI=0.57~0.67)和0.57(95%CI=0.49~0.67)。ATBC研究中的定期放射检查可能解释了为什么从巴赫模型观察到的癌症略多于预期。
The Bach model was developed to predict the absolute 10-year risk of developing lung cancer among smokers by use of participants in the Carotene and Retinol Efficacy Trial of lung cancer prevention. We assessed the validity of the Bach model among 6239 smokers from the placebo arm of the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Study. The expected numbers of lung cancer cases and deaths without lung cancer were calculated from the Bach model and compared with the observed numbers of corresponding events over 10 years. We found that the risk model slightly underestimated the observed lung cancer risk (number of lung cancers expected/number observed 0.89, 95% confidence interval [CI] 0.80 to 0.99) over 10 years. The competing risk portion of the model substantiafly underestimated risk of non-lung cancer mortality (number of non-lung cancer deaths expected/number observed = 0.61, 95% CI = 0.57 to 0.64) over 10 years. The age-specific concordance indices for 10-year predictions were 0.77 (95% CI = 0.70 to 0.84), 0.59 (95% CI = 0.53 to 0.65), 0.62 (95% CI = 0.57 to 0.67), and 0.57 (95% CI = 0.49 to 0.67) for the age groups 50-54, 55-59, 60-64, and 65-69 years, respectively. Periodic radiographic screening in the ATBC Study may explain why slightly more cancers were observed than expected from the Bach model.