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Author (up) Markaki, M.; Tsamardinos, I.; Langhammer, A.; Lagani, V.; Hveem, K.; Roe, O.D. url  doi
  Title A Validated Clinical Risk Prediction Model for Lung Cancer in Smokers of All Ages and Exposure Types: A HUNT Study Type Journal Article
  Year 2018 Publication EBioMedicine Abbreviated Journal EBioMedicine  
  Volume 31 Issue Pages 36-46  
  Keywords Adult; Aged; Aged, 80 and over; Databases, Factual; Female; Follow-Up Studies; Humans; Lung Neoplasms/*epidemiology; Male; Middle Aged; *Models, Biological; Norway; Predictive Value of Tests; Prospective Studies; *Registries; Risk Factors; *Smoking/adverse effects/epidemiology; All ages; All smokers; Data-driven; Early diagnosis; Ever-smokers; External validation; Feature selection; Lung cancer prediction  
  Abstract Lung cancer causes >1.6 million deaths annually, with early diagnosis being paramount to effective treatment. Here we present a validated risk assessment model for lung cancer screening. The prospective HUNT2 population study in Norway examined 65,237 people aged >20years in 1995-97. After a median of 15.2years, 583 lung cancer cases had been diagnosed; 552 (94.7%) ever-smokers and 31 (5.3%) never-smokers. We performed multivariable analyses of 36 candidate risk predictors, using multiple imputation of missing data and backwards feature selection with Cox regression. The resulting model was validated in an independent Norwegian prospective dataset of 45,341 ever-smokers, in which 675 lung cancers had been diagnosed after a median follow-up of 11.6years. Our final HUNT Lung Cancer Model included age, pack-years, smoking intensity, years since smoking cessation, body mass index, daily cough, and hours of daily indoors exposure to smoke. External validation showed a 0.879 concordance index (95% CI [0.866-0.891]) with an area under the curve of 0.87 (95% CI [0.85-0.89]) within 6years. Only 22% of ever-smokers would need screening to identify 81.85% of all lung cancers within 6years. Our model of seven variables is simple, accurate, and useful for screening selection.  
  Address Norwegian University of Science and Technology, Department of Clinical Research and Molecular Medicine, Prinsesse Kristinsgt. 1, Trondheim, NO 7491, Norway; Levanger Hospital, Nord-Trondelag Hospital Trust, Cancer Clinic, Kirkegata 2, Levanger, NO 7600, Norway; Clinical Cancer Research Center, Department of Clinical Medicine, Hobrovej 18-22, Aalborg, DK 9000, Denmark. Electronic address: oluf.roe@ntnu.no  
  Corporate Author Thesis  
  Publisher Place of Publication Editor  
  Language English Summary Language Original Title  
  Series Editor Series Title Abbreviated Series Title  
  Series Volume Series Issue Edition  
  ISSN 2352-3964 ISBN Medium  
  Area Expedition Conference  
  Notes PMID:29678673; PMCID:PMC6013755 Approved no  
  Call Number HUNT @ maria.stuifbergen @ Serial 2131  
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