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Development and validation of an individualized risk prediction model for oropharynx cancer in the US population
- Source :
- CancerReferences. 125(24)
- Publication Year :
- 2019
-
Abstract
- BACKGROUND The incidence of oropharynx cancers has increased substantially in the United States. However, risk stratification tools for the identification of high-risk individuals do not exist. In this study, an individualized risk prediction model was developed and validated for oropharynx cancers in the US population. METHODS A synthetic, US population-based case-control study was conducted. Oropharynx cancer cases diagnosed at Ohio State University (n = 241) were propensity-weighted to represent oropharynx cancers occurring annually in the United States during 2009-2014 (n = 12,656). Controls (n = 9327) included participants in the National Health and Nutrition Examination Survey (2009-2014) and represented the annual US population aged 30 to 69 years (n = 154,532,508). The individualized 1-year absolute risk of oropharynx cancer was estimated with weighted logistic regression. RESULTS The risk prediction model included age, sex, race, smoking, alcohol use, lifetime sexual partners, and oral oncogenic human papillomavirus (HPV) status. The model had good discrimination and calibration in split-sample validation (area under the curve [AUC], 0.94; 95% confidence interval [CI], 0.92-0.97; observed/expected [O/E], 1.01; 95% CI, 0.70-1.32) and external validation (AUC, 0.87; 95% CI, 0.84-0.90; O/E, 1.08; 95% CI, 0.77-1.39). In the US population, 1-year predicted risks of oropharynx cancer were highest for older individuals (21.1/100,000 for 65- to 69-year-olds), men (13.9/100,000), whites (10.4/100,000), smokers (18.0/100,000 for >20 pack-years), heavy alcohol users (18.4/100,000), and those with prevalent oral oncogenic HPV (140.4/100,000). The risk prediction model provided substantial risk stratification, with approximately 77% of all oropharynx cancers and approximately 99% of HPV-positive oropharynx cancers occurring in the 10% of the US population with the highest model-predicted risk. CONCLUSIONS This risk prediction model will enable the efficient design of studies to address the outstanding questions pertaining to the natural history, screening, and secondary prevention of oropharynx cancers.
- Subjects :
- Adult
Male
Cancer Research
National Health and Nutrition Examination Survey
Population
Logistic regression
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Risk Factors
medicine
Humans
030212 general & internal medicine
Registries
education
Propensity Score
Aged
Aged, 80 and over
education.field_of_study
business.industry
Incidence (epidemiology)
Incidence
Absolute risk reduction
Area under the curve
Cancer
Middle Aged
Models, Theoretical
medicine.disease
Confidence interval
United States
Oropharyngeal Neoplasms
Oncology
030220 oncology & carcinogenesis
Case-Control Studies
Female
Disease Susceptibility
business
Demography
Subjects
Details
- ISSN :
- 10970142
- Volume :
- 125
- Issue :
- 24
- Database :
- OpenAIRE
- Journal :
- CancerReferences
- Accession number :
- edsair.doi.dedup.....5055893868c628b0c5bfc22bc1d40b8d