Center for Prostate Cancer, National Cancer Center, Goyang, Korea.
Translational Research Branch, Research Institute, National Cancer Center, Goyang, Korea.
Cancer Res Treat. 2018 Oct;50(4):1194-1202. doi: 10.4143/crt.2017.484. Epub 2017 Dec 21.
The use of prostate-specific antigen as a biomarker for prostate cancer (PC) has been controversial and is, therefore, not used by many countries in their national health screening programs. The biological characteristics of PC in East Asians including Koreans and Japanese are different from those in the Western populations. Potential lifestyle risk factors for PC were evaluated with the aim of developing a risk prediction model.
A total of 1,179,172 Korean men who were cancer free from 1996 to 1997, had taken a physical examination, and completed a lifestyle questionnaire, were enrolled in our study to predict their risk for PC for the next eight years, using the Cox proportional hazards model. The model's performance was evaluated using the C-statistic and Hosmer‒Lemeshow type chi-square statistics.
The risk prediction model studied age, height, body mass index, glucose levels, family history of cancer, the frequency of meat consumption, alcohol consumption, smoking status, and physical activity, which were all significant risk factors in a univariate analysis. The model performed very well (C statistic, 0.887; 95% confidence interval, 0.879 to 0.895) and estimated an elevated PC risk in patients who did not consume alcohol or smoke, compared to heavy alcohol consumers (hazard ratio [HR], 0.78) and current smokers (HR, 0.73) (p < 0.001).
This model can be used for identifying Korean and other East Asian men who are at a high risk for developing PC, as well as for cancer screening and developing preventive health strategies.
前列腺特异性抗原（PSA）作为前列腺癌（PC）的生物标志物一直存在争议，因此，许多国家并未将其纳入国家健康筛查计划。东亚人群（包括韩国人和日本人）的前列腺癌生物学特征与西方人群不同。本研究评估了前列腺癌的潜在生活方式危险因素，旨在建立风险预测模型。
本研究共纳入 1179172 名 1996 至 1997 年无癌症、参加过体检并完成生活方式问卷调查的韩国男性，旨在预测他们在接下来 8 年内患前列腺癌的风险，采用 Cox 比例风险模型。采用 C 统计量和 Hosmer-Lemeshow 型 χ²检验评估模型性能。
该研究的风险预测模型研究了年龄、身高、体重指数、血糖水平、癌症家族史、肉类消费频率、饮酒、吸烟状况和身体活动，这些因素在单因素分析中均为显著的危险因素。该模型表现非常出色（C 统计量为 0.887；95%置信区间为 0.879 至 0.895），与重度饮酒者（HR，0.78）和当前吸烟者（HR，0.73）相比，不饮酒或不吸烟者的前列腺癌风险显著升高（p<0.001）。
该模型可用于识别韩国和其他东亚地区患前列腺癌风险较高的男性，也可用于癌症筛查和制定预防保健策略。
