Am J Epidemiol. 2020 Apr 2;189(4):330-342. doi: 10.1093/aje/kwz259.
Head and neck cancer (HNC) risk prediction models based on risk factor profiles have not yet been developed. We took advantage of the large database of the International Head and Neck Cancer Epidemiology (INHANCE) Consortium, including 14 US studies from 1981-2010, to develop HNC risk prediction models. Seventy percent of the data were used to develop the risk prediction models; the remaining 30% were used to validate the models. We used competing-risk models to calculate absolute risks. The predictors included age, sex, education, race/ethnicity, alcohol drinking intensity, cigarette smoking duration and intensity, and/or family history of HNC. The 20-year absolute risk of HNC was 7.61% for a 60-year-old woman who smoked more than 20 cigarettes per day for over 20 years, consumed 3 or more alcoholic drinks per day, was a high school graduate, had a family history of HNC, and was non-Hispanic white. The 20-year risk for men with a similar profile was 6.85%. The absolute risks of oropharyngeal and hypopharyngeal cancers were generally lower than those of oral cavity and laryngeal cancers. Statistics for the area under the receiver operating characteristic curve (AUC) were 0.70 or higher, except for oropharyngeal cancer in men. This HNC risk prediction model may be useful in promoting healthier behaviors such as smoking cessation or in aiding persons with a family history of HNC to evaluate their risks.
头颈部癌症(HNC)的风险预测模型基于危险因素谱尚未建立。我们利用国际头颈部癌症流行病学(INHANCE)联盟的大型数据库,包括 1981 年至 2010 年的 14 项美国研究,开发了 HNC 风险预测模型。70%的数据用于开发风险预测模型;其余 30%的数据用于验证模型。我们使用竞争风险模型来计算绝对风险。预测因子包括年龄、性别、教育程度、种族/民族、饮酒强度、吸烟持续时间和强度,以及/或 HNC 家族史。对于一位 60 岁的女性,每天吸烟超过 20 支,持续 20 年以上,每天饮用 3 份或更多份酒精饮料,为高中毕业生,有 HNC 家族史,且是非西班牙裔白人,其 20 年 HNC 的绝对风险为 7.61%。具有类似特征的男性的 20 年风险为 6.85%。口咽癌和下咽癌的绝对风险通常低于口腔癌和喉癌。除了男性的口咽癌外,接收者操作特征曲线(AUC)的统计数据为 0.70 或更高。这种 HNC 风险预测模型可能有助于促进更健康的行为,如戒烟,或帮助有 HNC 家族史的人评估他们的风险。