Assessing the feasibility of targeted screening for esophageal adenocarcinoma based on individual risk assessment in a population-based cohort study in Norway (The HUNT Study)

The American Journal of Gastroenterology
Shao-Hua XieJesper Lagergren

Abstract

Unselected screening for oesophageal adenocarcinoma (OAC) is not justified due to the low absolute risk in the general population. This study aimed to evaluate a risk prediction model in identifying high-risk individuals who might be considered for targeted screening. A population-based cohort of 62,576 participants was recruited in 1995-1997 in Nord-Trøndelag County, Norway (HUNT) and followed up until 31 December 2015. A model for predicting individuals' absolute risk of OAC was developed using competing-risk regression. The Lorenz curve was used to assess the concentration of OAC patients in high-risk individuals and the feasibility of targeted screening based on individual risk assessment. During 1,085,137 person-years of follow-up, 29 incident cases of OAC occurred. The model included risk factors for OAC, in which male sex, older age, gastro-oesophageal reflux symptoms, obesity, and tobacco smoking predicted higher risk of OAC. The area under the receiver operating characteristic curve for 10-year risk of OAC was 0.71 (95% confidence interval 0.57-0.85) and for 15-year risk was 0.84 (95% confidence interval 0.76-0.91) after 10-fold cross-validation, with good agreements between observed and predicted risks. The Lorenz cur...Continue Reading

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Citations

Apr 6, 2019·Alimentary Pharmacology & Therapeutics·Andrew T KunzmannHelen G Coleman
Oct 5, 2019·International Journal of Cancer. Journal International Du Cancer·Dag HolmbergJesper Lagergren
Aug 29, 2020·Cancer Epidemiology, Biomarkers & Prevention : a Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology·Shao-Hua XieJesper Lagergren
Apr 15, 2021·The American Journal of Gastroenterology·Joel H RubensteinDouglas A Corley
Nov 11, 2021·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Tarek SawasDavid A Katzka

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