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.
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ABSTRACT: BACKGROUND All patients with cirrhosis are at risk of developing hepatocellular carcinoma (HCC). This risk is not uniform because other patient-related factors influence the risk of HCC. The objective of the current study was to develop an HCC risk prediction model to estimate the 1-year probability of HCC to assist with patient counseling.METHODS Between 2002 and 2011, a cohort of 34,932 patients with cirrhosis was identified from a national liver transplantation waitlist database from the United States. Cox proportional hazards regression methods were used to develop and validate a risk prediction model for incident HCC. In the validation cohort, discrimination and calibration of the model was examined. External validation was conducted using patients with cirrhosis who were enrolled in the Hepatitis C Antiviral Long-term Treatment against Cirrhosis (HALT-C) study.RESULTSHCC developed in 1960 patients (5.6%) during a median follow-up of 1.3 years (interquartile range, 0.47 years-2.83 years). Six baseline clinical variables, including age, diabetes, race, etiology of cirrhosis, sex, and severity (ADRESS) of liver dysfunction were independently associated with HCC and were used to develop the ADRESS-HCC risk model. C-indices in the derivation and internal validation cohorts were 0.704 and 0.691, respectively. In the validation cohort, the predicted cumulative incidence of HCC by the ADRESS-HCC model closely matched the observed data. In patients with cirrhosis in the HALT-C cohort, the model stratified patients correctly according to the risk of developing HCC within 5 years.CONCLUSIONS The ADRESS-HCC risk model is a useful tool for predicting the 1-year risk of HCC among patients with cirrhosis. Cancer 2014. © 2014 American Cancer Society.Cancer 07/2014; · 5.20 Impact Factor
- OA Evidence-Based Medicine 2014 Jan 18;2(1):1. 07/2014;
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ABSTRACT: In many developed countries, socioeconomic status is associated with cancer incidence and survival. However, research in Japan is sparse. We examined the association between neighborhood deprivation based on the Japanese Deprivation Index and the risk of incidence, mortality and survival from total and major cancers in the Japan Public Health Center-based Prospective Study.PLoS ONE 09/2014; 9(9):e106729. · 3.53 Impact Factor