An epidemiological model for prediction of endometrial cancer risk in Europe.

Eur J Epidemiol 2016 Jan 13;31(1):51-60. Epub 2015 May 13.

Division of Cancer Epidemiology (C020), German Cancer Research Center (DKFZ), Im Neuenheimer Feld 581, 69120, Heidelberg, Germany.

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.

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http://dx.doi.org/10.1007/s10654-015-0030-9DOI Listing
January 2016
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References

(Supplied by CrossRef)

J Ferlay et al.
Eur J Cancer 2013

AG Renehan et al.
Lancet 2008

V Beral et al.
Lancet 2005

NE Allen et al.
Am J Epidemiol 2010

L Dossus et al.
Int J Cancer 2010

Z Haoula et al.
Hum Reprod 2012

R Kaaks et al.
Cancer Epidemiol Biomark Prev 2002

HS Taylor et al.
J Clin Endocrinol Metab 2011

JV Lacey Jr et al.
Int J Cancer 2012

S Yang et al.
Trends Endocrinol Metab 2011

MH Gail et al.
Stat Med 2011

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