LLPi: Liverpool Lung Project Risk Prediction Model for Lung Cancer Incidence
Menée à partir de données portant sur une cohorte de 8 760 participants (âge : de 45 à 79 ans ; durée moyenne de suivi : 8,7 ans), cette étude évalue la performance d'un modèle mathématique, basé sur des facteurs de risque associés au cancer du poumon (âge et sexe des patients, durée du tabagisme, antécédents familiaux de cancer du poumon), pour identifier les patients présentant un risque élevé de développer la maladie
Identification of high risk individuals will facilitate early diagnosis, reduce overall costs and also improve the current poor survival from lung cancer. The Liverpool Lung Project prospective cohort of 8760 participants aged 45-79 years, recruited between 1998 and 2008, were followed annually through the hospital episode statistics until 31 January 2013. Cox proportional hazards models were used to identify risk predictors of lung cancer incidence. C-statistic was used to assess the discriminatory accuracy of the models. Models were internally validated using bootstrap method. During mean follow-up of 8.7 years, 237 participants developed lung cancer. Age (hazard ratio [HR] 1.04; 95%CI, 1.02-1.06), male gender (HR 1.48; 95%CI:1.10-1.98), smoking duration (HR 1.04; 95%CI 1.03-1.05), COPD (HR 2.43; 95%CI 1.79-3.30), prior diagnosis of malignant tumour (HR 2.84; 95%CI 2.08-3.89) and early onset of family history of lung cancer (HR 1.68;95%CI 1.04-2.72) were associated with the incidence of lung cancer. The LLPi risk model had a good calibration (goodness-of-fit χ2 7.58, P=0.371). The apparent C-statistic was 0.852(95%CI 0.831-0.873) and the optimism-corrected bootstrap resampling C-statistic was 0.849 (95% CI of 0.829-0.873). The LLPi risk model may assist in identifying individuals at high risk of developing lung cancer in population-based screening programs.
Cancer Prevention Research , résumé, 2015