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Development and External Validation of a Melanoma Risk Prediction Model Based on Self-assessed Risk Factors.
Vuong, Kylie; Armstrong, Bruce K; Weiderpass, Elisabete; Lund, Eiliv; Adami, Hans-Olov; Veierod, Marit B; Barrett, Jennifer H; Davies, John R; Bishop, D Timothy; Whiteman, David C; Olsen, Catherine M; Hopper, John L; Mann, Graham J; Cust, Anne E; McGeechan, Kevin.
Afiliación
  • Vuong K; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, University of Sydney, Sydney, Australia2School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia.
  • Armstrong BK; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, University of Sydney, Sydney, Australia.
  • Weiderpass E; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway4Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden5Department of Research, Cancer R.
  • Lund E; Department of Community Medicine, Faculty of Health Sciences, University of Tromsø, Arctic University of Norway, Tromsø, Norway.
  • Adami HO; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden7Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.
  • Veierod MB; Oslo Centre for Biostatistics and Epidemiology, Department of Biostatistics, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway.
  • Barrett JH; Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, Leeds University, Leeds, United Kingdom.
  • Davies JR; Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, Leeds University, Leeds, United Kingdom.
  • Bishop DT; Leeds Institute of Cancer and Pathology, Faculty of Medicine and Health, Leeds University, Leeds, United Kingdom.
  • Whiteman DC; Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
  • Olsen CM; Population Health Department, QIMR Berghofer Medical Research Institute, Brisbane, Australia.
  • Hopper JL; Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.
  • Mann GJ; Centre for Cancer Research, Westmead Institute for Medical Research, University of Sydney, Westmead, Australia13Melanoma Institute Australia, University of Sydney, North Sydney, Australia.
  • Cust AE; Cancer Epidemiology and Prevention Research, Sydney School of Public Health, University of Sydney, Sydney, Australia13Melanoma Institute Australia, University of Sydney, North Sydney, Australia.
  • McGeechan K; Sydney School of Public Health, University of Sydney, Sydney, Australia.
JAMA Dermatol ; 152(8): 889-96, 2016 08 01.
Article en En | MEDLINE | ID: mdl-27276088
IMPORTANCE: Identifying individuals at high risk of melanoma can optimize primary and secondary prevention strategies. OBJECTIVE: To develop and externally validate a risk prediction model for incident first-primary cutaneous melanoma using self-assessed risk factors. DESIGN, SETTING, AND PARTICIPANTS: We used unconditional logistic regression to develop a multivariable risk prediction model. Relative risk estimates from the model were combined with Australian melanoma incidence and competing mortality rates to obtain absolute risk estimates. A risk prediction model was developed using the Australian Melanoma Family Study (629 cases and 535 controls) and externally validated using 4 independent population-based studies: the Western Australia Melanoma Study (511 case-control pairs), Leeds Melanoma Case-Control Study (960 cases and 513 controls), Epigene-QSkin Study (44 544, of which 766 with melanoma), and Swedish Women's Lifestyle and Health Cohort Study (49 259 women, of which 273 had melanoma). MAIN OUTCOMES AND MEASURES: We validated model performance internally and externally by assessing discrimination using the area under the receiver operating curve (AUC). Additionally, using the Swedish Women's Lifestyle and Health Cohort Study, we assessed model calibration and clinical usefulness. RESULTS: The risk prediction model included hair color, nevus density, first-degree family history of melanoma, previous nonmelanoma skin cancer, and lifetime sunbed use. On internal validation, the AUC was 0.70 (95% CI, 0.67-0.73). On external validation, the AUC was 0.66 (95% CI, 0.63-0.69) in the Western Australia Melanoma Study, 0.67 (95% CI, 0.65-0.70) in the Leeds Melanoma Case-Control Study, 0.64 (95% CI, 0.62-0.66) in the Epigene-QSkin Study, and 0.63 (95% CI, 0.60-0.67) in the Swedish Women's Lifestyle and Health Cohort Study. Model calibration showed close agreement between predicted and observed numbers of incident melanomas across all deciles of predicted risk. In the external validation setting, there was higher net benefit when using the risk prediction model to classify individuals as high risk compared with classifying all individuals as high risk. CONCLUSIONS AND RELEVANCE: The melanoma risk prediction model performs well and may be useful in prevention interventions reliant on a risk assessment using self-assessed risk factors.
Asunto(s)

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Cutáneas / Carcinoma Basocelular / Carcinoma de Células Escamosas / Medición de Riesgo / Melanoma / Nevo Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male / Middle aged País/Región como asunto: Europa / Oceania Idioma: En Revista: JAMA Dermatol Año: 2016 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias Cutáneas / Carcinoma Basocelular / Carcinoma de Células Escamosas / Medición de Riesgo / Melanoma / Nevo Tipo de estudio: Diagnostic_studies / Etiology_studies / Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adolescent / Adult / Aged / Aged80 / Child / Female / Humans / Male / Middle aged País/Región como asunto: Europa / Oceania Idioma: En Revista: JAMA Dermatol Año: 2016 Tipo del documento: Article País de afiliación: Australia Pais de publicación: Estados Unidos