دورية أكاديمية
Predicting risk of endometrial cancer in asymptomatic women (PRECISION): Model development and external validation.
| العنوان: | Predicting risk of endometrial cancer in asymptomatic women (PRECISION): Model development and external validation. |
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| المؤلفون: | Kitson SJ; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK., Crosbie EJ; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.; Department of Obstetrics and Gynaecology, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK., Evans DG; Genomic Medicine, Division of Evolution Infection and Genomic Sciences, University of Manchester, Manchester, UK., Lophatananon A; Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK., Muir KR; Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK., Ashcroft D; Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.; NIHR Greater Manchester Patient Safety Translational Research Centre (PSTRC), University of Manchester, Manchester, UK., Kontopantelis E; Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK., Martin GP; Division of Informatics, Imaging and Data Science, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK. |
| المصدر: | BJOG : an international journal of obstetrics and gynaecology [BJOG] 2024 Jun; Vol. 131 (7), pp. 996-1005. Date of Electronic Publication: 2023 Dec 10. |
| نوع المنشور: | Journal Article; Validation Study |
| اللغة: | English |
| بيانات الدورية: | Publisher: Wiley-Blackwell Country of Publication: England NLM ID: 100935741 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1471-0528 (Electronic) Linking ISSN: 14700328 NLM ISO Abbreviation: BJOG Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Original Publication: Oxford [England] : Blackwell Science, [2000]- |
| مواضيع طبية MeSH: | Endometrial Neoplasms*/epidemiology, Humans ; Female ; Middle Aged ; Risk Assessment/methods ; United Kingdom/epidemiology ; Risk Factors ; Cohort Studies ; Body Mass Index ; Asymptomatic Diseases/epidemiology ; Waist Circumference ; Age Factors |
| مستخلص: | Objectives: Develop an endometrial cancer risk prediction model and externally validate it for UK primary care use. Design: Cohort study. Setting: The UK Biobank was used for model development and a linked primary (Clinical Practice Research Datalink, CPRD) and secondary care (HES), mortality (ONS) and cancer register (NRCAS) dataset was used for external validation. Population: Women aged 45-60 years with no history of endometrial cancer or hysterectomy. Methods: Model development was performed using a flexible parametric survival model and stepwise backward selection aiming to minimise the Akaike information criterion. Model performance on external validation was assessed through flexible calibration plots, calculation of the expected to observed ratio and C-statistic and decision curve analysis. Main Outcome Measures: Endometrial cancer diagnosis within 1-10 years of the index date. Results: Model development included 222 031 women (902 incident endometrial cancer cases) and external validation 3 094 371 women (8585 endometrial cancer cases). The final model (with equation provided) incorporated age, body mass index, waist circumference, age at menarche, menopause and last birth, hormone replacement, tamoxifen and oral contraceptive pill use, type 2 diabetes, smoking and family history of bowel cancer. It was well calibrated on external validation (calibration slope 1.14, 95% confidence interval [CI] 1.11-1.17, E/O 1.03, 95% CI 1.01-1.05), with moderate/good discrimination (C-statistic 0.70, 95% CI 0.69-0.70) and had improved net benefit compared with previously developed models. Conclusions: The Predicting risk of endometrial cancer in asymptomatic women model (PRECISION), using easily measurable anthropometric, reproductive, personal and family history, accurately quantifies a woman's 10-year risk of endometrial cancer. Its use could determine eligibility for primary endometrial cancer prevention trials and for targeted resource allocation in UK general practices. (© 2023 The Authors. BJOG: An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd.) |
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| معلومات مُعتمدة: | PRF101 National Institute for Health and Care Research; Wellbeing of Women; NIHR300650 NIHR Advanced Fellowship; IS-BRC-1215-20007 NIHR Manchester Biomedical Research Centre; 101017441 European Union; PSTRC-2016-003 NIHR Greater Manchester Patient Safety Translational Research Centre |
| فهرسة مساهمة: | Keywords: endometrial cancer; model; prediction; prevention; risk |
| تواريخ الأحداث: | Date Created: 20231211 Date Completed: 20240426 Latest Revision: 20240426 |
| رمز التحديث: | 20240426 |
| DOI: | 10.1111/1471-0528.17729 |
| PMID: | 38073256 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1471-0528 |
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| DOI: | 10.1111/1471-0528.17729 |