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An epidemiological model for prediction of endometrial cancer risk in Europe

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Title: An epidemiological model for prediction of endometrial cancer risk in Europe
Authors: Huesing, A
Dossus, L
Ferrari, P
Tjonneland, A
Hansen, L
Fagherazzi, G
Baglietto, L
Schock, H
Chang-Claude, J
Boeing, H
Steffen, A
Trichopoulou, A
Bamia, C
Katsoulis, M
Krogh, V
Palli, D
Panico, S
Onland-Moret, NC
Peeters, PH
Bueno-de-Mesquita, HB
Weiderpass, E
Gram, IT
Ardanaz, E
Obon-Santacana, M
Navarro, C
Sanchez-Cantalejo, E
Etxezarreta, N
Allen, NE
Khaw, KT
Wareham, N
Rinaldi, S
Romieu, I
Merritt, MA
Gunter, M
Riboli, E
Kaaks, R
Item Type: Journal Article
Abstract: Endometrial cancer (EC) is the fourth most frequent cancer in women in Europe, and as its incidence is increasing, prevention strategies gain further pertinence. Risk prediction models can be a useful tool for identifying women likely to benefit from targeted prevention measures. On the basis of data from 201,811 women (mostly aged 30–65 years) including 855 incident EC cases from eight countries in the European Prospective Investigation into Cancer and Nutrition cohort, a model to predict EC was developed. A step-wise model selection process was used to select confirmed predictive epidemiologic risk factors. Piece-wise constant hazard rates in 5-year age-intervals were estimated in a cause-specific competing risks model, five-fold-cross-validation was applied for internal validation. Risk factors included in the risk prediction model were body-mass index (BMI), menopausal status, age at menarche and at menopause, oral contraceptive use, overall and by different BMI categories and overall duration of use, parity, age at first full-term pregnancy, duration of menopausal hormone therapy and smoking status (specific for pre, peri- and post-menopausal women). These variables improved the discriminating capacity to predict risk over 5 years from 71 % for a model based on age alone to 77 % (overall C statistic), and the model was well-calibrated (ratio of expected to observed cases = 0.99). Our model could be used for the identification of women at increased risk of EC in Western Europe. To achieve an EC-risk model with general validity, a large-scale cohort-consortium approach would be needed to assess and adjust for population variation.
Issue Date: 13-May-2015
Date of Acceptance: 7-Apr-2015
URI: http://hdl.handle.net/10044/1/42280
DOI: http://dx.doi.org/10.1007/s10654-015-0030-9
ISSN: 1573-7284
Publisher: Springer Verlag
Start Page: 51
End Page: 60
Journal / Book Title: European Journal of Epidemiology
Volume: 31
Issue: 1
Copyright Statement: © Springer Verlag 2015. The final publication is available at Springer via http://dx.doi.org/10.1007/s10654-015-0030-9.
Keywords: Science & Technology
Life Sciences & Biomedicine
Public, Environmental & Occupational Health
Endometrial cancer
Risk model
Epidemiology
Prevention
POSTMENOPAUSAL WOMEN
HORMONE-THERAPY
NUTRITION
METAANALYSIS
CARCINOMA
COHORT
Endometrial cancer
Epidemiology
Prevention
Risk model
Adult
Aged
Body Mass Index
Endometrial Neoplasms
Europe
Female
Humans
Incidence
Menopause
Middle Aged
Models, Biological
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors
Humans
Endometrial Neoplasms
Body Mass Index
Incidence
Risk Assessment
Risk Factors
Prospective Studies
Predictive Value of Tests
Menopause
Models, Biological
Adult
Aged
Middle Aged
Europe
Female
Epidemiology
1117 Public Health And Health Services
Publication Status: Published
Appears in Collections:Faculty of Medicine
Epidemiology, Public Health and Primary Care



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