Development and internal validation of a multifactorial risk prediction model for gallbladder cancer in a high-incidence country
Autor
Boekstegers, Felix
Scherer, Dominique
Barahona Ponce, Carol
Marcelain, Katherine
Gárate-Calderón, Valentina
Waldenberger, Melanie
Morales, Erik
Rojas, Armando
Munoz, César
Retamales, Javier
de Toro, Gonzalo
Barajas, Olga
Rivera, María Teresa
Cortés, Analía
Loader, Denisse
Saavedra, Javiera
Gutiérrez, Lorena
Ortega, Alejandro
Bertrán, Maria Enriqueta
Bartolotti, Leonardo
Gabler, Fernando
Campos, Mónica
Alvarado, Juan
Moisán, Fabricio
Spencer, Loreto
Nervi, Bruno
Carvajal-Hausdorf, Daniel
Losada, Héctor
Almau, Mauricio
Fernández, Plinio
Olloquequi, Jordi
Fuentes-Guajardo, Macarena
Gonzalez-Jose, Rolando
Bortolini, Maria Cátira
Acuña-Alonzo, Victor
Gallo, Carla
Linares, Andres Ruiz
Rothhammer, Francisco
Lorenzo Bermejo, Justo
Resumen
Since 2006, Chile has been implementing a gallbladder cancer (GBC) prevention program based on prophylactic cholecystectomy for gallstone patients aged 35 to 49 years. The effectiveness of this prevention program has not yet been comprehensively evaluated. We conducted a retrospective study of 473 Chilean GBC patients and 2137 population-based controls to develop and internally validate three GBC risk prediction models. The Baseline Model accounted for gallstones while adjusting for sex and birth year. Enhanced Model I also included the non-genetic risk factors: body mass index, educational level, Mapuche surnames, number of children and family history of GBC. Enhanced Model II further included Mapuche ancestry and the genotype for rs17209837. Multiple Cox regression was applied to assess the predictive performance, quantified by the area under the precision-recall curve (AUC-PRC) and the number of cholecystectomies needed (NCN) to prevent one case of GBC at age 70 years. The AUC-PRC for the Baseline Model (0.44%, 95%CI 0.42-0.46) increased by 0.22 (95%CI 0.15-0.29) when non-genetic factors were included, and by 0.25 (95%CI 0.20-0.30) when incorporating non-genetic and genetic factors. The overall NCN for Chileans with gallstones (115, 95%CI 104-131) decreased to 92 (95%CI 60-128) for Chileans with a higher risk than the median according to Enhanced Model I, and to 80 (95%CI 59-110) according to Enhanced Model II. In conclusion, age, sex and gallstones are strong risk factors for GBC, but consideration of other non-genetic factors and individual genotype data improves risk prediction and may optimize allocation of financial resources and surgical capacity. © 2023 The Authors. International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
Colecciones
Ítems relacionados
Mostrando ítems relacionados por Título, autor o materia.
-
Article
Gallbladder Cancer Risk and Indigenous South American Mapuche Ancestry: Instrumental Variable Analysis Using Ancestry-Informative Markers (2024)
Zollner, Linda; Boekstegers, Felix; Barahona Ponce, Carol; Scherer, Dominique; Marcelain, Katherine; Gárate-Calderón, Valentina; Waldenberger, Melanie; Morales, Erik; Rojas, Armando; Munoz, César; ... (Multidisciplinary Digital Publishing Institute (MDPI), 2023)A strong association between the proportion of indigenous South American Mapuche ancestry and the risk of gallbladder cancer (GBC) has been reported in observational studies. Chileans show the highest incidence of GBC ... -
Article
ABCB1/4 gallbladder cancer risk variants identified in India also show strong effects in Chileans (2020)
Boekstegers F.; Marcelain K.; Barahona Ponce C.; Baez Benavides P.F.; Müller B.; de Toro G.; Retamales J.; Barajas O.; Ahumada M.; Morales E.; ... (Elsevier Ltd, 2020) -
Article
Gallstones, Body Mass Index, C-Reactive Protein, and Gallbladder Cancer: Mendelian Randomization Analysis of Chilean and European Genotype Data (2021)
Barahona Ponce, Carol; Scherer, Dominique; Brinster, Regina; Boekstegers, Felix; Marcelain, Katherine; Gárate-Calderón, Valentina; Müller, Bettina G.; de Toro, Gonzalo; Retamales, Javier; Barajas, Olga; ... (John Wiley and Sons Inc, 2021-05)Background and Aims: Gallbladder cancer (GBC) is a neglected disease with substantial geographical variability: Chile shows the highest incidence worldwide, while GBC is relatively rare in Europe. Here, we investigate the ...