Biometric Research Branch, National Cancer Center, Goyang, Republic of Korea.
PLoS One. 2013;8(2):e54823. doi: 10.1371/journal.pone.0054823. Epub 2013 Feb 7.
Lung cancer is the leading cause of cancer deaths in Korea. The objective of the present study was to develop an individualized risk prediction model for lung cancer in Korean men using population-based cohort data.
From a population-based cohort study of 1,324,804 Korean men free of cancer at baseline, the individualized absolute risk of developing lung cancer was estimated using the Cox proportional hazards model. We checked the validity of the model using C statistics and the Hosmer-Lemeshow chi-square test on an external validation dataset.
The risk prediction model for lung cancer in Korean men included smoking exposure, age at smoking initiation, body mass index, physical activity, and fasting glucose levels. The model showed excellent performance (C statistic = 0.871, 95% CI = 0.867-0.876). Smoking was significantly associated with the risk of lung cancer in Korean men, with a four-fold increased risk in current smokers consuming more than one pack a day relative to non-smokers. Age at smoking initiation was also a significant predictor for developing lung cancer; a younger age at initiation was associated with a higher risk of developing lung cancer.
This is the first study to provide an individualized risk prediction model for lung cancer in an Asian population with very good model performance. In addition to current smoking status, earlier exposure to smoking was a very important factor for developing lung cancer. Since most of the risk factors are modifiable, this model can be used to identify those who are at a higher risk and who can subsequently modify their lifestyle choices to lower their risk of lung cancer.
肺癌是韩国癌症死亡的主要原因。本研究的目的是利用基于人群的队列数据为韩国男性开发一种用于肺癌的个体化风险预测模型。
本研究基于一项针对 1324804 名韩国男性的基于人群的队列研究，在基线时无癌症，使用 Cox 比例风险模型估计发生肺癌的个体化绝对风险。我们使用 C 统计量和 Hosmer-Lemeshow 卡方检验在外部验证数据集上检查了模型的有效性。
韩国男性肺癌风险预测模型包括吸烟暴露、吸烟起始年龄、体重指数、身体活动和空腹血糖水平。该模型表现出优异的性能（C 统计量=0.871，95%CI=0.867-0.876）。吸烟与韩国男性肺癌风险显著相关，与不吸烟者相比，每天吸烟超过一包的当前吸烟者肺癌风险增加了四倍。吸烟起始年龄也是发生肺癌的一个重要预测因素；起始年龄越小，发生肺癌的风险越高。
这是第一项针对亚洲人群提供肺癌个体化风险预测模型的研究，该模型具有非常好的性能。除了当前的吸烟状况外，较早接触吸烟也是发生肺癌的一个非常重要的因素。由于大多数风险因素是可以改变的，因此该模型可用于识别那些风险较高的人群，随后他们可以改变生活方式选择来降低肺癌风险。
