Validation of the Harvard Cancer Risk Index: a prediction tool for individual cancer risk
Validation of the Harvard Cancer Risk Index: a prediction tool for individual cancer risk
复制标题
DOI：
10.1016/j.jclinepi.2003.08.013
复制
发表时间：
2004-04-01
影响因子：
7.2
通讯作者：
Colditz, GA
中科院分区：
文献类型：
--
作者：
Kim, DJ;Rockhill, B;Colditz, GA
目的：风险评估工具越来越多地用于临床环境，以估计个人患疾病和死于疾病的风险。哈佛癌症风险指数就是这样一种工具，它被构建来预测40岁及以上的个体相对于普通人群在美国男性和女性中发展为主要类型癌症的风险。迄今为止，风险指数尚未进行前瞻性validated.Study设计和设置：在一个为期10年的护士的健康研究和卫生专业人员的随访研究，年龄标准化的发病率为卵巢癌，结肠癌和胰腺癌的风险指数的相对风险类别进行计算，以评估适合的风险预测在总体水平。调整后的一致性统计数据被确定为措施的歧视性准确性在个人level.Results：风险指数进行了很好的校准，观察到的相对风险跨类别的卵巢癌和结肠癌的妇女和胰腺癌的男性，而它表现为中度结肠癌的男性。对卵巢癌的鉴别准确性适中（年龄调整一致性统计= 0.59），对胰腺癌相对较好（一致性统计为0.72），以及男性和女性的结肠癌（一致性统计值分别为0.71、0.67）。这项前瞻性验证的结果为风险指数在预测个人癌症风险方面的有效性提供了证据，从而为该风险评估工具的进一步应用提供支持。(C)2004年爱思唯尔公司All rights reserved.
Objective: Risk appraisal tools are increasingly being used in the clinical setting to estimate individuals' risks of developing and dying from diseases. The Harvard Cancer Risk Index is one such tool constructed to predict the risks of individuals, aged 40 and above, for developing the leading types of cancer in U.S. men and women relative to the general population. To date, the Risk Index has not been prospectively validated.Study Design and Setting: Over a period of 10 years' follow-up in the Nurses' Health Study and the Health Professionals' Followup Study, age-standardized incidence ratios for cancer of the ovary, colon, and pancreas were calculated for the Risk Index's relative risk categories to assess goodness of fit for risk prediction at the aggregate level. Age-adjusted concordance statistics were determined as measures of discriminatory accuracy at the individual level.Results: The Risk Index was well calibrated with observed relative risks across categories for ovarian and colon cancer in women and pancreatic cancer in men, while it performed moderately for colon cancer in men. Discriminatory accuracy was modest for ovarian cancer (age-adjusted concordance statistic = 0.59), and relatively good for pancreatic cancer (concordance statistic of 0.72), and colon cancer in men and women (concordance statistics of 0.71, 0.67 respectively).Conclusion: The results of this prospective validation provide evidence for the validity of the Risk Index in predicting individuals' risks of cancers, and thereby offer support for future applications of this risk appraisal tool. (C) 2004 Elsevier Inc. All rights reserved.