Lung cancer risk score for ever and never smokers in China

查看全文 作　　者：Zhimin [1,2,3]Ma;Jun [4,5]Lv;Meng [1,2]Zhu;Canqing [4]Yu;Hongxia [1,2]Ma;Guangfu [1,2]Jin;Yu [6]Guo;Zheng [6]Bian;Ling [7]Yang;Yiping [7]Chen;Zhengming [7]Chen;Zhibin [1,2]Hu;Liming [4,7]Li;Hongbing [1,2,8]Shen

机构地区：[1]Department of Epidemiology,Center for Global Health,School of Public Health,Nanjing Medical University,Nanjing,Jiangsu,P.R.China;[2]Jiangsu Key Lab of Cancer Biomarkers,Prevention and Treatment,Collaborative Innovation Center for Cancer Personalized Medicine,Nanjing Medical University,Nanjing,Jiangsu,P.R.China;[3]Department of Epidemiology,School of Public Health,Southeast University,Nanjing,Jiangsu,P.R.China;[4]Department of Epidemiology&Biostatistics,School of Public Health,Peking University,Beijing,P.R.China;[5]Ministry of Education,Key Laboratory of Molecular Cardiovascular Sciences(Peking University),Beijing,P.R.China;[6]Chinese Academy of Medical Sciences,Beijing,P.R.China;[7]Clinical Trial Service Unit&Epidemiological Studies Unit(CTSU),Nuffield Department of Population Health,University of Oxford,Oxford,Oxfordshire,UK;[8]Research Units of Cohort Study on Cardiovascular Diseases and Cancers,Chinese Academy of Medical Sciences,Beijing,P.R.China

出　　处：《Cancer Communications》索引2023年第43卷第8期,共19页

基　　金：National Natural Science Foundation of China,Grant/Award Numbers:81820108028,81922061,81973123,82273714,82192901,82192904,82192900;Excellent Youth Foundation of Jiangsu Province,Grant/Award Number:BK20220100;Research Unit of Prospective Cohort of Cardiovascular Diseases and Cancer;Chinese Academy of Medical Sciences,Grant/Award Number:2019RU038;Science and Technology Service Network Initiative of Chinese Academy of Sciences,Grant/Award Number:No.KFJ-STS-QYZD-2021-08-001;the National Key Research and Development Program of China,Grant/Award Number:2016YFC0900500。 摘　　要：Background:Most lung cancer risk prediction models were developed in European and North-American cohorts of smokers aged≥55 years,while less is known about risk profiles in Asia,especially for never smokers or individuals aged<50 years.Hence,we aimed to develop and validate a lung cancer risk estimate tool for ever and never smokers across a wide age range.Methods:Based on the China Kadoorie Biobank cohort,we first systematically selected the predictors and explored the nonlinear association of predictors with lung cancer risk using restricted cubic splines.Then,we separately developed risk prediction models to construct a lung cancer risk score(LCRS)in 159,715 ever smokers and 336,526 never smokers.The LCRS was further validated in an independent cohort over a median follow-up of 13.6 years,consisting of 14,153 never smokers and 5,890 ever smokers.Results:A total of 13 and 9 routinely available predictors were identified for ever and never smokers,respectively.Of these predictors,cigarettes per day and quit years showed nonlinear associations with lung cancer risk(Pnon-linear<0.001).The curve of lung cancer incidence increased rapidly above 20 cigarettes per day and then was relatively flat until approximately 30 cigarettes per day.We also observed that lung cancer risk declined sharplywithin the first 5 years of quitting,and then continued to decrease but at a slower rate in the subsequent years.The 6-year area under the receiver operating curve for the ever and never smokers’models were respectively 0.778 and 0.733 in the derivation cohort,and 0.774 and 0.759 in the validation cohort.In the validation cohort,the 10-year cumulative incidence of lung cancerwas 0.39%and 2.57%for ever smokers with low(<166.2)and intermediate-high LCRS(≥166.2),respectively.Never smokers with a high LCRS(≥21.2)had a higher 10-year cumulative incidence rate than those with a low LCRS(<21.2;1.05%vs.0.22%).An online risk evaluation tool(LCKEY;http://gffzz0332d520339f4200hbuf5kucnuu056nb6.ffgz.tsg.suse.edu.cn/lckey/web)was developed to facilitate the use of LCRS.Conclusions:The LCRS can be an effective risk assessment tool designed for ever and never smokers aged 30 to 80 years. 关键词：early-onset cancer lung cancer screening lung cancer never smokers prediction model

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Lung cancer risk score for ever and never smokers in China

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