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

作者：Alison P. Klein, Sara Lindström, Julie B. Mendelsohn, Emily Steplowski, Alan A. Arslan, H. Bas Bueno-de-Mesquita, Charles S. Fuchs, Steven Gallinger, Myron D. Gross, Kathy J. Helzlsouer, Elizabeth A. Holly, Eric J. Jacobs, Andrea Z. LaCroix, Donghui Li, Margaret T. Mandelson, Sara H. Olson, Gloria M. Petersen, Harvey A. Risch, Rachael Z. Stolzenberg‐Solomon, Wei Zheng, Laufey T. Ámundadóttir, Demetrius Albanes, Naomi E. Allen, William R. Bamlet, Marie‐Christine Boutron‐Ruault, Julie E. Buring, Paige M. Bracci, Federico Canzian, Sandra Clipp, Michelle Cotterchio, Eric J. Duell, Joanne W. Elena, J. Michael Gaziano, Edward L. Giovannucci, Michael Goggins, Göran Hallmans, Manal M. Hassan, Amy Hutchinson, David J. Hunter, Charles Kooperberg, Robert C. Kurtz, Simin Liu, Kim Overvad, Domenico Palli, Alpa V. Patel, Kari G. Rabe, Xiao-Ou Shu, Nadia Slimani, Geoffrey S. Tobias, Dimitrios Trichopoulos, Stephen K. Van Den Eeden, Paolo Vineis, Jarmo Virtamo, Jean Wactawski‐Wende, Brian M. Wolpin, Herbert Yu, Kai Yu, Anne Zeleniuch‐Jacquotte, Stephen J. Chanock, Robert N. Hoover, Patricia Hartge, Peter Kraft · 发表于：PLoS ONE · 年份：2013 · DOI：10.1371/journal.pone.0072311 · 被引用次数：150 · 研究领域：Pancreatic and Hepatic Oncology Research、Pancreatitis Pathology and Treatment、Biological Research and Disease Studies

PURPOSE: We developed an absolute risk model to identify individuals in the general population at elevated risk of pancreatic cancer. 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. 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 (>3 drinks/day) (OR: 1.45 [1.19-1.76]), obesity (body mass index >30 kg/m(2)) (OR: 1.26 [1.09-1.45]), diabetes >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. CONCLUSION: Although absolute risk modeling using established risk factors may help...