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Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations
BACKGROUND: Effective risk prediction models are lacking for personalized endoscopic screening of gastric cancer (GC). We aimed to develop, validate, and evaluate a questionnaire-based GC risk assessment tool for risk prediction and stratification in the Chinese population. METHODS: In this three-st...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2023
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142220/ https://www.ncbi.nlm.nih.gov/pubmed/37106459 http://dx.doi.org/10.1186/s12916-023-02864-0 |
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author | Zhu, Xia Lv, Jun Zhu, Meng Yan, Caiwang Deng, Bin Yu, Canqing Guo, Yu Ni, Jing She, Qiang Wang, Tianpei Wang, Jiayu Jiang, Yue Chen, Jiaping Hang, Dong Song, Ci Gao, Xuefeng Wu, Jian Dai, Juncheng Ma, Hongxia Yang, Ling Chen, Yiping Song, Mingyang Wei, Qingyi Chen, Zhengming Hu, Zhibin Shen, Hongbing Ding, Yanbing Li, Liming Jin, Guangfu |
author_facet | Zhu, Xia Lv, Jun Zhu, Meng Yan, Caiwang Deng, Bin Yu, Canqing Guo, Yu Ni, Jing She, Qiang Wang, Tianpei Wang, Jiayu Jiang, Yue Chen, Jiaping Hang, Dong Song, Ci Gao, Xuefeng Wu, Jian Dai, Juncheng Ma, Hongxia Yang, Ling Chen, Yiping Song, Mingyang Wei, Qingyi Chen, Zhengming Hu, Zhibin Shen, Hongbing Ding, Yanbing Li, Liming Jin, Guangfu |
author_sort | Zhu, Xia |
collection | PubMed |
description | BACKGROUND: Effective risk prediction models are lacking for personalized endoscopic screening of gastric cancer (GC). We aimed to develop, validate, and evaluate a questionnaire-based GC risk assessment tool for risk prediction and stratification in the Chinese population. METHODS: In this three-stage multicenter study, we first selected eligible variables by Cox regression models and constructed a GC risk score (GCRS) based on regression coefficients in 416,343 subjects (aged 40–75 years) from the China Kadoorie Biobank (CKB, development cohort). In the same age range, we validated the GCRS effectiveness in 13,982 subjects from another independent Changzhou cohort (validation cohort) as well as in 5348 subjects from an endoscopy screening program in Yangzhou. Finally, we categorized participants into low (bottom 20%), intermediate (20–80%), and high risk (top 20%) groups by the GCRS distribution in the development cohort. RESULTS: The GCRS using 11 questionnaire-based variables demonstrated a Harrell’s C-index of 0.754 (95% CI, 0.745–0.762) and 0.736 (95% CI, 0.710–0.761) in the two cohorts, respectively. In the validation cohort, the 10-year risk was 0.34%, 1.05%, and 4.32% for individuals with a low (≤ 13.6), intermediate (13.7~30.6), and high (≥ 30.7) GCRS, respectively. In the endoscopic screening program, the detection rate of GC varied from 0.00% in low-GCRS individuals, 0.27% with intermediate GCRS, to 2.59% with high GCRS. A proportion of 81.6% of all GC cases was identified from the high-GCRS group, which represented 28.9% of all the screened participants. CONCLUSIONS: The GCRS can be an effective risk assessment tool for tailored endoscopic screening of GC in China. Risk Evaluation for Stomach Cancer by Yourself (RESCUE), an online tool was developed to aid the use of GCRS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-023-02864-0. |
format | Online Article Text |
id | pubmed-10142220 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-101422202023-04-29 Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations Zhu, Xia Lv, Jun Zhu, Meng Yan, Caiwang Deng, Bin Yu, Canqing Guo, Yu Ni, Jing She, Qiang Wang, Tianpei Wang, Jiayu Jiang, Yue Chen, Jiaping Hang, Dong Song, Ci Gao, Xuefeng Wu, Jian Dai, Juncheng Ma, Hongxia Yang, Ling Chen, Yiping Song, Mingyang Wei, Qingyi Chen, Zhengming Hu, Zhibin Shen, Hongbing Ding, Yanbing Li, Liming Jin, Guangfu BMC Med Research Article BACKGROUND: Effective risk prediction models are lacking for personalized endoscopic screening of gastric cancer (GC). We aimed to develop, validate, and evaluate a questionnaire-based GC risk assessment tool for risk prediction and stratification in the Chinese population. METHODS: In this three-stage multicenter study, we first selected eligible variables by Cox regression models and constructed a GC risk score (GCRS) based on regression coefficients in 416,343 subjects (aged 40–75 years) from the China Kadoorie Biobank (CKB, development cohort). In the same age range, we validated the GCRS effectiveness in 13,982 subjects from another independent Changzhou cohort (validation cohort) as well as in 5348 subjects from an endoscopy screening program in Yangzhou. Finally, we categorized participants into low (bottom 20%), intermediate (20–80%), and high risk (top 20%) groups by the GCRS distribution in the development cohort. RESULTS: The GCRS using 11 questionnaire-based variables demonstrated a Harrell’s C-index of 0.754 (95% CI, 0.745–0.762) and 0.736 (95% CI, 0.710–0.761) in the two cohorts, respectively. In the validation cohort, the 10-year risk was 0.34%, 1.05%, and 4.32% for individuals with a low (≤ 13.6), intermediate (13.7~30.6), and high (≥ 30.7) GCRS, respectively. In the endoscopic screening program, the detection rate of GC varied from 0.00% in low-GCRS individuals, 0.27% with intermediate GCRS, to 2.59% with high GCRS. A proportion of 81.6% of all GC cases was identified from the high-GCRS group, which represented 28.9% of all the screened participants. CONCLUSIONS: The GCRS can be an effective risk assessment tool for tailored endoscopic screening of GC in China. Risk Evaluation for Stomach Cancer by Yourself (RESCUE), an online tool was developed to aid the use of GCRS. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12916-023-02864-0. BioMed Central 2023-04-27 /pmc/articles/PMC10142220/ /pubmed/37106459 http://dx.doi.org/10.1186/s12916-023-02864-0 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Zhu, Xia Lv, Jun Zhu, Meng Yan, Caiwang Deng, Bin Yu, Canqing Guo, Yu Ni, Jing She, Qiang Wang, Tianpei Wang, Jiayu Jiang, Yue Chen, Jiaping Hang, Dong Song, Ci Gao, Xuefeng Wu, Jian Dai, Juncheng Ma, Hongxia Yang, Ling Chen, Yiping Song, Mingyang Wei, Qingyi Chen, Zhengming Hu, Zhibin Shen, Hongbing Ding, Yanbing Li, Liming Jin, Guangfu Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations |
title | Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations |
title_full | Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations |
title_fullStr | Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations |
title_full_unstemmed | Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations |
title_short | Development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in Chinese populations |
title_sort | development, validation, and evaluation of a risk assessment tool for personalized screening of gastric cancer in chinese populations |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10142220/ https://www.ncbi.nlm.nih.gov/pubmed/37106459 http://dx.doi.org/10.1186/s12916-023-02864-0 |
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