Development of a prediction model for 10-year risk of hepatocellular carcinoma in middle-aged Japanese: The Japan Public Health Center-based Prospective Study Cohort II
ABSTRACT The purpose of the present study was to develop a risk estimation model for the 10-year risk of hepatocellular carcinoma (HCC) that could be easily used in a general population to aid in the prevention of HCC.
Our prediction model was derived from data obtained on 17,654 Japanese aged 40 to 69 years who participated in health checkups (follow-up: 1993-2006). Cox proportional hazards regression was applied to obtain coefficients for each predictor.
During follow-up, a total of 104 cases of HCC were newly diagnosed. After checking the model fit, we incorporated age, sex, alcohol consumption, body mass index, diabetes, coffee consumption, and hepatitis B and C virus infection into the prediction model. The model showed satisfactory discrimination (Harrell's c-index=0.94) and was well calibrated (the overall observed/expected ratio=1.03, 95% confidence interval=0.83-1.29). We also developed a simple risk scoring system. Those subjects with total scores of 17 or more under this system (score range: -1 to 19) had an estimated 10-year HCC risk of over 90%; those with 4 points or less had an estimated risk of less than 0.1%.
We developed a simple 10-year risk prediction model for HCC in the Japanese general population as a public education tool.
- Preventive Medicine 08/2012; 55(2):144-5. DOI:10.1016/j.ypmed.2012.06.011 · 2.93 Impact Factor
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ABSTRACT: OBJECTIVE: The commentary offers a discussion of the further study of translational research for preventive medicine. METHODS: We introduce an exemplary episode in a recent publication of ours in Preventive Medicine, discuss difficulty in grasping the properties of preventive medicine, and refer to our trial of putting prediction model applications on the internet that calculate changes in risk through lifestyle modification. RESULTS: We argue that how the basic findings in preventive medicine get translated into actual preventive practices will depend very much on the situation and environment. CONCLUSION: Preventive Medicine will help develop the role of translational research in preventive medicine in its reporting and serve as a forum for various translation possibilities and take a leading role in discussing the philosophy of epidemiology.Preventive Medicine 08/2012; 55(6). DOI:10.1016/j.ypmed.2012.08.012 · 2.93 Impact Factor
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ABSTRACT: Background: Growing awareness of the potential to predict a person's future risk of cancer has resulted in the development of numerous algorithms. Such algorithms aim to improve the ability of policy makers, doctors and patients to make rational decisions about behaviour modification or surveillance, with the expectation that this activity will lead to overall benefit. There remains debate however, about whether accurate risk prediction is achievable for most cancers. Methods: We conducted a brief narrative review of the literature regarding the history and challenges of risk prediction, highlighting our own recent experiences in developing tools for oesophageal adenocarcinoma. Results and conclusions: While tools for predicting future risk of cardiovascular outcomes have been translated successfully to clinical practice, the experience with cancer risk prediction has been mixed. Models have now been developed and validated for predicting risk of melanoma and cancers of the breast, colo-rectum, lung, liver, oesophagus and prostate, and while several of these have adequate performance at the population-level, none to date have adequate discrimination for predicting risk in individual patients. Challenges of individual risk prediction for cancer are many, and include long latency, multiple risk factors of mostly small effect, and incomplete knowledge of the causal pathways.05/2013; 37(4). DOI:10.1016/j.canep.2013.04.002