亚洲常吸烟者的肺癌风险预测模型
Jae Jeong Yang1, Wanqing Wen2, Hana Zahed3
1Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Surgery, University of Florida College of Medicine, Gainesville, Florida; University of Florida Health Cancer Center, Gainesville, Florida.
概括
现有的肺癌预测模型低估了亚洲人群的风险. 新的"上海模型"显示亚洲低强度吸烟者和长期戒烟者的准确性有所提高.
科学领域:
- 在瘤学瘤学.
- 流行病学 流行病学
- 生物统计学 生物统计学
背景情况:
- 肺癌风险预测模型对于有针对性的查至关重要.
- 西方开发的模型对亚洲人口的通用性是不确定的.
- 准确的风险评估对于有效的肺癌预防策略至关重要.
研究的目的:
- 评估11个现有的肺癌风险预测模型在不同亚洲人群中的性能.
- 开发和验证精细的肺癌风险预测模型,专门针对亚洲人群.
- 通过现有模型解决在特定亚洲亚组中低估肺癌风险的问题.
主要方法:
- 从19个潜在队伍中对186,458名亚洲常吸烟者的综合分析.
- 评估模型校准 (预期与观测的比率) 和歧视 (接收器运行特征曲线 (AUC) 下的面积).
- 使用基于人口的潜在队列开发和外部验证新的"上海模型".
主要成果:
- 肺癌死亡风险评估工具显示AUC最高 (0.71为死亡,0.69为发病率).
- 现有的模型低估了亚洲吸烟者的风险,他们的吸烟年数小于10包或20年前戒烟.
- "上海模式"显示了边际的整体歧视改善,但在低强度吸烟者和长期戒烟者中表现优于西方模式.
结论:
- "上海车型"的整体性能与现有的顶级车型相提并论.
- 这些新模型显著提高了亚洲低强度吸烟者和长期戒烟者的肺癌风险预测准确度.
- 需要改进模型,以提高不同亚洲人群的肺癌查效率.
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