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Title: An epidemiological model for prediction of endometrial cancer risk in Europe.
Authors: Hüsing, Anika
Dossus, Laure
Ferrari, Pietro
Tjønneland, Anne
Hansen, Louise
Fagherazzi, Guy
Baglietto, Laura
Schock, Helena
Chang-Claude, Jenny
Boeing, Heiner
Steffen, Annika
Trichopoulou, Antonia
Bamia, Christina
Katsoulis, Michalis
Krogh, Vittorio
Palli, Domenico
Panico, Salvatore
Onland-Moret, N Charlotte
Peeters, Petra H
Bueno-de-Mesquita, H Bas
Weiderpass, Elisabete
Gram, Inger T
Ardanaz, Eva
Obón-Santacana, Mireia
Navarro, Carmen
Sánchez-Cantalejo, Emilio
Etxezarreta, Nerea
Allen, Naomi E
Khaw, Kay Tee
Wareham, Nick
Rinaldi, Sabina
Romieu, Isabelle
Merritt, Melissa A
Gunter, Marc
Riboli, Elio
Kaaks, Rudolf
Keywords: Endometrial cancer;Epidemiology;Prevention;Risk model
metadata.dc.subject.mesh: Adult
Body Mass Index
Endometrial Neoplasms
Middle Aged
Models, Biological
Predictive Value of Tests
Prospective Studies
Risk Assessment
Risk Factors
Issue Date: 13-May-2015
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.
metadata.dc.identifier.doi: 10.1007/s10654-015-0030-9
Appears in Collections:Producción 2020

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