External validation of models for predicting risk of colorectal cancer using the China Kadoorie Biobank.
External validation of models for predicting risk of colorectal cancer using the China Kadoorie Biobank.
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DOI：
10.1186/s12916-022-02488-w
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发表时间：
2022-09-08
期刊：
影响因子：
9.3
通讯作者：
Kartsonaki, Christiana
中科院分区：
文献类型：
--
作者：
Abhari, Roxanna E.;Thomson, Blake;Yang, Ling;Millwood, Iona;Guo, Yu;Yang, Xiaoming;Lv, Jun;Avery, Daniel;Pei, Pei;Wen, Peng;Yu, Canqing;Chen, Yiping;Chen, Junshi;Li, Liming;Chen, Zhengming;Kartsonaki, Christiana
在中国，结直肠癌（CRC）的发病率和死亡率在过去几十年中一直在稳步上升。预测 CRC 事件的风险模型已在不同人群中开发出来，但尚未在中国人群中进行系统的外部验证。 本研究旨在利用中国嘉道理生物样本库 (CKB) 评估风险评分在预测 CRC 方面的表现，CKB 是中国规模最大、分布广泛的前瞻性队列研究之一。九个模型在 CKB 的 512,415 名参与者中进行了外部验证，其中包括 2976 例 CRC 病例。使用受试者工作特征曲线下面积（AUC）对模型歧视进行整体评估，并按性别、年龄、地点和地理位置进行评估。将这九个模型的模型歧视与仅使用年龄的模型进行比较。对五个模型进行了校准评估，并在 CKB 中重新校准。区分度最高的三个模型（Ma（Cox 模型）AUC 0.70 [95% CI 0.69–0.71]；Aleksandrova 0.70 [0.69–0.71]；Hong 0.69 [0.67–0.71]）包括变量年龄、吸烟和饮酒。这些模型的表现明显优于仅基于年龄的模型（AUC 为 0.65 [95% CI 0.64–0.66]）。年轻参与者、男性、城市环境和结肠癌的模型歧视普遍较高。在中国人群中开发的两个模型（郭和陈）的表现并不比其他模型更好。在风险最高的 10% 参与者中，三个表现最好的模型识别出 24-26% 的参与者继续发展为 CRC。一些基于容易获得的人口统计和可改变的生活方式因素的风险模型在中国人群中具有良好的区分度。三个表现最好的模型比使用仅基于年龄的模型具有更高的辨别力。在线版本包含可在 10.1186/s12916-022-02488-w 获取的补充材料。
In China, colorectal cancer (CRC) incidence and mortality have been steadily increasing over the last decades. Risk models to predict incident CRC have been developed in various populations, but they have not been systematically externally validated in a Chinese population. This study aimed to assess the performance of risk scores in predicting CRC using the China Kadoorie Biobank (CKB), one of the largest and geographically diverse prospective cohort studies in China. Nine models were externally validated in 512,415 participants in CKB and included 2976 cases of CRC. Model discrimination was assessed, overall and by sex, age, site, and geographic location, using the area under the receiver operating characteristic curve (AUC). Model discrimination of these nine models was compared to a model using age alone. Calibration was assessed for five models, and they were re-calibrated in CKB. The three models with the highest discrimination (Ma (Cox model) AUC 0.70 [95% CI 0.69–0.71]; Aleksandrova 0.70 [0.69–0.71]; Hong 0.69 [0.67–0.71]) included the variables age, smoking, and alcohol. These models performed significantly better than using a model based on age alone (AUC of 0.65 [95% CI 0.64–0.66]). Model discrimination was generally higher in younger participants, males, urban environments, and for colon cancer. The two models (Guo and Chen) developed in Chinese populations did not perform better than the others. Among the 10% of participants with the highest risk, the three best performing models identified 24–26% of participants that went on to develop CRC. Several risk models based on easily obtainable demographic and modifiable lifestyle factor have good discrimination in a Chinese population. The three best performing models have a higher discrimination than using a model based on age alone. The online version contains supplementary material available at 10.1186/s12916-022-02488-w.
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DOI：
10.1016/j.amjgastroenterol.2203.09.041
发表时间：
2003-12-01
影响因子：
9.8
作者：
Betés, M;Muñoz-Navas, MA;Martínez-González, MA
通讯作者：
Martínez-González, MA
影响因子：
24.5
作者：
Imperiale, Thomas F.;Monahan, Patrick O.;Ransohoff, David F.
通讯作者：
Ransohoff, David F.
影响因子：
5.1
作者：
Chen, Guochang;Mao, Boneng;Ning, Yueji
通讯作者：
Ning, Yueji
影响因子：
6
作者：
Kalinowski, Agnieszka;Humphreys, Keith
通讯作者：
Humphreys, Keith
性别和抗拓扑异构酶 I 抗体在系统性硬化症中的影响
影响因子：
16.400
作者：
Rossella De Angelis
通讯作者：
Rossella De Angelis