Butala Neel M, Al-Hammadi Noor, Ediriwickrema Asiri, Schneider Jaime L, Fullerton Aaron, Balasubramanian Jeya, Choudhury Parichoy Pal, Chatterjee Nilanjan
Department of Medicine, University of Colorado School of Medicine, Aurora, CO.
Department of Medicine, Rocky Mountain Regional VA Medical Center, Aurora, CO.
medRxiv. 2025 Jul 24:2025.07.23.25326097. doi: 10.1101/2025.07.23.25326097.
Technological advances and direct-to-consumer marketing have unearthed significant organic demand from patients for cancer screening and prevention. However, in the absence of strong data or guidelines, physicians have minimal support on how to approach patients in clinical practice.
We projected individualized probabilities of 10-year and lifetime cancer risk across a population as well as potential improvement with healthy behaviors in the UK Biobank.
A total of 118 distinct variables were included across 38 cancer-specific models. The distribution of lifetime cancer risk had a rightward skew and wide variation for both men and women. The median lifetime cancer risk was 29.5% for men (interquartile range (IQR) 8.4%) and 21.0% for women (IQR 8.8%). If all modifiable risk factors were set to the ideal state, this decreased to 20.5% for men (IQR 3.9%) and 16.5% for women (IQR 4.9%). There was considerable overlap between age groups, with men aged 50-59 at the 90 percentile having greater risk (11.9%) than men aged 60-70 at the 25 percentile (11.8%), and women aged 40-49 at the 90 percentile having greater risk (7.4%) than women aged 50-59 at the 60 percentile (6.8%) and women aged 60-70 at the 20 percentile (7.3%).
Lifetime cancer risk varies widely across the UK Biobank cohort, but this risk decreases substantially with healthy behaviors. There was considerable overlap in 10-year cancer risk between age groups, suggesting that future multicancer screening guidelines should account for more than age and sex as more evidence becomes available in the future.
技术进步和直接面向消费者的营销挖掘出了患者对癌症筛查和预防的巨大潜在需求。然而,在缺乏有力数据或指南的情况下,医生在临床实践中如何对待患者几乎得不到支持。
我们在英国生物银行中预测了整个人口中10年和终生患癌风险的个体化概率以及健康行为可能带来的改善。
38个特定癌症模型共纳入了118个不同变量。男性和女性的终生患癌风险分布呈右偏态且差异很大。男性终生患癌风险的中位数为29.5%(四分位间距(IQR)8.4%),女性为21.0%(IQR 8.8%)。如果所有可改变的风险因素都设定为理想状态,男性这一比例降至20.5%(IQR 3.9%),女性降至16.5%(IQR 4.9%)。不同年龄组之间存在相当大的重叠,90百分位数的50 - 59岁男性的风险(11.9%)高于25百分位数的60 - 70岁男性(11.8%),90百分位数的40 - 49岁女性的风险(7.4%)高于60百分位数的50 - 59岁女性(6.8%)和20百分位数的60 - 70岁女性(7.3%)。
在英国生物银行队列中,终生患癌风险差异很大,但这种风险通过健康行为会大幅降低。不同年龄组之间10年患癌风险存在相当大的重叠,这表明随着未来有更多证据可用,未来的多癌筛查指南应考虑年龄和性别以外的更多因素。