An Absolute Risk Model to Identify Individuals at Elevated Risk for Pancreatic Cancer in the General Population

作者：Klein Alison P^*; Lindstroem Sara; Mendelsohn Julie B; Steplowski Emily; Arslan Alan A; Bueno de Mesquita H Bas; Fuchs Charles S; Gallinger Steven; Gross Myron; Helzlsouer Kathy; Holly Elizabeth A; Jacobs Eric J; LaCroix Andrea; Li Donghui; Mandelson Margaret T; Olson Sara H; Petersen Gloria M; Risch Harvey A; Stolzenberg Solomon Rachael Z; Zheng Wei; Amundadottir Laufey; Albanes Demetrius; Allen Naomi E; Bamlet William R; Boutron Ruault Marie Christine

来源：PLos One, 2013, 8(9): e72311.

DOI：10.1371/journal.pone.0072311

Purpose: We developed an absolute risk model to identify individuals in the general population at elevated risk of pancreatic cancer. %26lt;br%26gt;Patients and Methods: Using data on 3,349 cases and 3,654 controls from the PanScan Consortium, we developed a relative risk model for men and women of European ancestry based on non-genetic and genetic risk factors for pancreatic cancer. We estimated absolute risks based on these relative risks and population incidence rates. %26lt;br%26gt;Results: Our risk model included current smoking (multivariable adjusted odds ratio (OR) and 95% confidence interval: 2.20 [1.84-2.62]), heavy alcohol use (%26gt;3 drinks/day) (OR: 1.45 [1.19-1.76]), obesity (body mass index %26gt;30 kg/m(2)) (OR: 1.26 [1.09-1.45]), diabetes %26gt;3 years (nested case-control OR: 1.57 [1.13-2.18], case-control OR: 1.80 [1.40-2.32]), family history of pancreatic cancer (OR: 1.60 [1.20-2.12]), non-O ABO genotype (AO vs. OO genotype) (OR: 1.23 [1.10-1.37]) to (BB vs. OO genotype) (OR 1.58 [0.97-2.59]), rs3790844(chr1q32.1) (OR: 1.29 [1.19-1.40]), rs401681(5p15.33) (OR: 1.18 [1.10-1.26]) and rs9543325(13q22.1) (OR: 1.27 [1.18-1.36]). The areas under the ROC curve for risk models including only non-genetic factors, only genetic factors, and both non-genetic and genetic factors were 58%, 57% and 61%, respectively. We estimate that fewer than 3/1,000 U. S. non-Hispanic whites have more than a 5% predicted lifetime absolute risk. %26lt;br%26gt;Conclusion: Although absolute risk modeling using established risk factors may help to identify a group of individuals at higher than average risk of pancreatic cancer, the immediate clinical utility of our model is limited. However, a risk model can increase awareness of the various risk factors for pancreatic cancer, including modifiable behaviors.

• 出版日期2013-9-13
• 单位NIH