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Published in: BMC Cancer 1/2019

Open Access 01-12-2019 | Breast Disease | Research article

Risk prediction for breast Cancer in Han Chinese women based on a cause-specific Hazard model

Authors: Lu Wang, Liyuan Liu, Zhen Lou, Lijie Ding, Hui Guan, Fei Wang, Lixiang Yu, Yujuan Xiang, Fei Zhou, Fuzhong Xue, Zhigang Yu

Published in: BMC Cancer | Issue 1/2019

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Abstract

Background

Considering the lack of efficient breast cancer prediction models suitable for general population screening in China. We aimed to develop a risk prediction model to identify high-risk populations, to help with primary prevention of breast cancer among Han Chinese women.

Methods

A cause-specific competing risk model was used to develop the Han Chinese Breast Cancer Prediction model. Data from the Shandong Case-Control Study (328 cases and 656 controls) and Taixing Prospective Cohort Study (13,176 participants) were used to develop and validate the model. The expected/observed (E/O) ratio and C-statistic were calculated to evaluate calibration and discriminative accuracy of the model, respectively.

Results

Compared with the reference level, the relative risks (RRs) for highest level of number of abortions, age at first live birth, history of benign breast disease, body mass index (BMI), family history of breast cancer, and life satisfaction scores were 6.3, 3.6, 4.3, 1.9, 3.3, 2.4, respectively. The model showed good calibration and discriminatory accuracy with an E/O ratio of 1.03 and C-statistic of 0.64.

Conclusions

We developed a risk prediction model including fertility status and relevant disease history, as well as other modifiable risk factors. The model demonstrated good calibration and discrimination ability.
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Literature
1.
go back to reference Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108.CrossRef Torre LA, Bray F, Siegel RL, Ferlay J, Lortet-Tieulent J, Jemal A. Global cancer statistics, 2012. CA Cancer J Clin. 2015;65:87–108.CrossRef
2.
go back to reference Yu ZG, Jia CX, Liu LY, Geng CZ, Tang JH, Zhang J, et al. The prevalence and correlates of breast cancer among women in eastern China. PLoS One. 2012;7:e37784.CrossRef Yu ZG, Jia CX, Liu LY, Geng CZ, Tang JH, Zhang J, et al. The prevalence and correlates of breast cancer among women in eastern China. PLoS One. 2012;7:e37784.CrossRef
3.
go back to reference Wang B, He M, Wang L, Engelgau MM, Zhao W, Wang L. Breast cancer screening among adult women in China, 2010. Prev Chronic Dis. 2013;10:E183.CrossRef Wang B, He M, Wang L, Engelgau MM, Zhao W, Wang L. Breast cancer screening among adult women in China, 2010. Prev Chronic Dis. 2013;10:E183.CrossRef
4.
go back to reference Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst. 1989;81:1879–86.CrossRef Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, et al. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst. 1989;81:1879–86.CrossRef
5.
go back to reference Cuzick J, Forbes J, Edwards R, Baum M, Cawthorn S, Coates A, et al. First results from the international breast Cancer intervention study (IBIS-I): a randomised prevention trial. Lancet. 2002;360:817–24.CrossRef Cuzick J, Forbes J, Edwards R, Baum M, Cawthorn S, Coates A, et al. First results from the international breast Cancer intervention study (IBIS-I): a randomised prevention trial. Lancet. 2002;360:817–24.CrossRef
6.
go back to reference Costantino JP, Gail MH, Pee D, Anderson S, Redmond CK, Benichou J, et al. Validation studies for models projecting the risk of invasive and total breast cancer incidence. J Natl Cancer Inst. 1999;91:1541–8.CrossRef Costantino JP, Gail MH, Pee D, Anderson S, Redmond CK, Benichou J, et al. Validation studies for models projecting the risk of invasive and total breast cancer incidence. J Natl Cancer Inst. 1999;91:1541–8.CrossRef
7.
go back to reference Rockhill B, Spiegelman D, Byrne C, Hunter DJ, Colditz GA. Validation of the Gail et al. model of breast cancer risk prediction and implications for chemoprevention. J Natl Cancer Inst. 2001. Rockhill B, Spiegelman D, Byrne C, Hunter DJ, Colditz GA. Validation of the Gail et al. model of breast cancer risk prediction and implications for chemoprevention. J Natl Cancer Inst. 2001.
8.
go back to reference Kaur JS, Roubidoux MA, Sloan J, Novotny P. Can the Gail model be useful in American Indian and Alaska native populations? Cancer. 2004. Kaur JS, Roubidoux MA, Sloan J, Novotny P. Can the Gail model be useful in American Indian and Alaska native populations? Cancer. 2004.
9.
go back to reference Novotny J, Pecen L, Petruzelka L, Svobodnik A, Dusek L, Danes J, et al. Breast cancer risk assessment in the Czech female population - an adjustment of the original Gail model. Breast Cancer Res Treat. 2006. Novotny J, Pecen L, Petruzelka L, Svobodnik A, Dusek L, Danes J, et al. Breast cancer risk assessment in the Czech female population - an adjustment of the original Gail model. Breast Cancer Res Treat. 2006.
10.
go back to reference Boyle P, Mezzetti M, La Vecchia C, Franceschi S, Decarli A, Robertson C. Contribution of three components to individual cancer risk predicting breast cancer risk in Italy. Eur J Cancer Prev. 2004. Boyle P, Mezzetti M, La Vecchia C, Franceschi S, Decarli A, Robertson C. Contribution of three components to individual cancer risk predicting breast cancer risk in Italy. Eur J Cancer Prev. 2004.
11.
go back to reference Gao F, Machin D, Chow KY, Sim YF, Duffy SW, Matchar DB, et al. Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study). BMC Cancer. 2012. Gao F, Machin D, Chow KY, Sim YF, Duffy SW, Matchar DB, et al. Assessing risk of breast cancer in an ethnically South-East Asia population (results of a multiple ethnic groups study). BMC Cancer. 2012.
12.
go back to reference Tyrer J, Duffy SW, Cuzick J. A breast cancer prediction model incorporating familial and personal risk factors. Stat Med. 2004;23:1111–30.CrossRef Tyrer J, Duffy SW, Cuzick J. A breast cancer prediction model incorporating familial and personal risk factors. Stat Med. 2004;23:1111–30.CrossRef
13.
go back to reference Cao W, Wang X, Li JC. Hereditary breast cancer in the Han Chinese population. J Epidemiol. 2013;23:75–84.CrossRef Cao W, Wang X, Li JC. Hereditary breast cancer in the Han Chinese population. J Epidemiol. 2013;23:75–84.CrossRef
14.
go back to reference Wang F, Yu L, Wang F, Liu L, Guo M, Gao D, et al. Risk factors for breast cancer in women residing in urban and rural areas of eastern China. J Int Med Res. 2015;43:774–89.CrossRef Wang F, Yu L, Wang F, Liu L, Guo M, Gao D, et al. Risk factors for breast cancer in women residing in urban and rural areas of eastern China. J Int Med Res. 2015;43:774–89.CrossRef
15.
go back to reference Zhou B. Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population. Zhonghua Liu Xing Bing Xue Za Zhi. 2002;23:5–10.PubMed Zhou B. Predictive values of body mass index and waist circumference to risk factors of related diseases in Chinese adult population. Zhonghua Liu Xing Bing Xue Za Zhi. 2002;23:5–10.PubMed
16.
go back to reference Bruzzi P, Green SB, Byar DP, Brinton LA, Schairer C. Estimating the population attributable risk for multiple risk factors using case-control data. Am J Epidemiol. 1985;122:904–14.CrossRef Bruzzi P, Green SB, Byar DP, Brinton LA, Schairer C. Estimating the population attributable risk for multiple risk factors using case-control data. Am J Epidemiol. 1985;122:904–14.CrossRef
17.
go back to reference Gail MH, Costantino JP, Pee D, Bondy M, Newman L, Selvan M, et al. Projecting individualized absolute invasive breast cancer risk in African American women. J Natl Cancer Inst. 2007;99:1782–92.CrossRef Gail MH, Costantino JP, Pee D, Bondy M, Newman L, Selvan M, et al. Projecting individualized absolute invasive breast cancer risk in African American women. J Natl Cancer Inst. 2007;99:1782–92.CrossRef
18.
go back to reference Wang Y, Gao Y, Battsend M, Chen K, Lu W, Wang Y. Development of a risk assessment tool for projecting individualized probabilities of developing breast cancer for Chinese women. Tumour Biol. 2014;35:10861–9.CrossRef Wang Y, Gao Y, Battsend M, Chen K, Lu W, Wang Y. Development of a risk assessment tool for projecting individualized probabilities of developing breast cancer for Chinese women. Tumour Biol. 2014;35:10861–9.CrossRef
19.
go back to reference Gail MH. Personalized estimates of breast cancer risk in clinical practice and public health. Stat Med. 2011;30:1090–104.CrossRef Gail MH. Personalized estimates of breast cancer risk in clinical practice and public health. Stat Med. 2011;30:1090–104.CrossRef
20.
go back to reference Norris Susan L, Zhang X, Avenell A, Gregg E, Brown T, Schmid Christopher H, et al. Long-term non-pharmacological weight loss interventions for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005. Norris Susan L, Zhang X, Avenell A, Gregg E, Brown T, Schmid Christopher H, et al. Long-term non-pharmacological weight loss interventions for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev. 2005.
21.
go back to reference Appel LJ, Clark JM, Yeh H-C, Wang N-Y, Coughlin JW, Daumit G, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011;365:1959–68.CrossRef Appel LJ, Clark JM, Yeh H-C, Wang N-Y, Coughlin JW, Daumit G, et al. Comparative effectiveness of weight-loss interventions in clinical practice. N Engl J Med. 2011;365:1959–68.CrossRef
22.
go back to reference Chavier-Roper RG, Alick-Ortiz S, Davila-Plaza G, Morales-Quinones AG. The relationship between diabetes mellitus and body mass index primary care facility in PUERTO RICO. Bol Asoc Med P R. 2014;106:17–21.PubMed Chavier-Roper RG, Alick-Ortiz S, Davila-Plaza G, Morales-Quinones AG. The relationship between diabetes mellitus and body mass index primary care facility in PUERTO RICO. Bol Asoc Med P R. 2014;106:17–21.PubMed
23.
go back to reference Gray N, Picone G, Sloan F, Yashkin A. The relationship between BMI and onset of diabetes mellitus and its complications. South Med J. 2015;108:29–36.CrossRef Gray N, Picone G, Sloan F, Yashkin A. The relationship between BMI and onset of diabetes mellitus and its complications. South Med J. 2015;108:29–36.CrossRef
24.
go back to reference Wang L, Liu H, Zhang S, Leng J, Liu G, Zhang C, et al. Obesity index and the risk of diabetes among Chinese women with prior gestational diabetes. Diabet Med. 2014;31:1368–77.CrossRef Wang L, Liu H, Zhang S, Leng J, Liu G, Zhang C, et al. Obesity index and the risk of diabetes among Chinese women with prior gestational diabetes. Diabet Med. 2014;31:1368–77.CrossRef
25.
go back to reference Bao W, Yeung E, Tobias DK, Hu FB, Vaag AA, Chavarro JE, et al. Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study. Diabetologia. 2015;58:1212–9.CrossRef Bao W, Yeung E, Tobias DK, Hu FB, Vaag AA, Chavarro JE, et al. Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus: a prospective cohort study. Diabetologia. 2015;58:1212–9.CrossRef
26.
go back to reference Boyle P, Boniol M, Koechlin A, Robertson C, Valentini F, Coppens K, et al. Diabetes and breast cancer risk: a meta-analysis. Br J Cancer. 2012;107:1608–17.CrossRef Boyle P, Boniol M, Koechlin A, Robertson C, Valentini F, Coppens K, et al. Diabetes and breast cancer risk: a meta-analysis. Br J Cancer. 2012;107:1608–17.CrossRef
27.
go back to reference Kaaks R. Nutrition, hormones, and breast cancer: is insulin the missing link? Cancer Causes Control. 1996;7:605–25.CrossRef Kaaks R. Nutrition, hormones, and breast cancer: is insulin the missing link? Cancer Causes Control. 1996;7:605–25.CrossRef
28.
go back to reference Rosner W. The functions of corticosteroid-binding globulin and sex hormone-binding globulin: recent advances. Endocr Rev. 1990;11:80–91.CrossRef Rosner W. The functions of corticosteroid-binding globulin and sex hormone-binding globulin: recent advances. Endocr Rev. 1990;11:80–91.CrossRef
29.
go back to reference Plymate SR, Hoop RC, Jones RE, Matej LA. Regulation of sex hormone-binding globulin production by growth factors. Metabolism. 1990;39:967–70.CrossRef Plymate SR, Hoop RC, Jones RE, Matej LA. Regulation of sex hormone-binding globulin production by growth factors. Metabolism. 1990;39:967–70.CrossRef
30.
go back to reference Suga K, Imai K, Eguchi H, Hayashi S, Higashi Y, Nakachi K. Molecular significance of excess body weight in postmenopausal breast cancer patients, in relation to expression of insulin-like growth factor I receptor and insulin-like growth factor II genes. Jpn J Cancer Res. 2001;92:127–34.CrossRef Suga K, Imai K, Eguchi H, Hayashi S, Higashi Y, Nakachi K. Molecular significance of excess body weight in postmenopausal breast cancer patients, in relation to expression of insulin-like growth factor I receptor and insulin-like growth factor II genes. Jpn J Cancer Res. 2001;92:127–34.CrossRef
31.
go back to reference Oerlemans ME, van den Akker M, Schuurman AG, Kellen E, Buntinx F. A meta-analysis on depression and subsequent cancer risk. Clin Pr Epidemiol Ment Heal. 2007;3:29.CrossRef Oerlemans ME, van den Akker M, Schuurman AG, Kellen E, Buntinx F. A meta-analysis on depression and subsequent cancer risk. Clin Pr Epidemiol Ment Heal. 2007;3:29.CrossRef
32.
go back to reference Wakai K, Kojima M, Nishio K, Suzuki S, Niwa Y, Lin Y, et al. Psychological attitudes and risk of breast cancer in Japan: a prospective study. Cancer Causes Control. 2007;18:259–67.CrossRef Wakai K, Kojima M, Nishio K, Suzuki S, Niwa Y, Lin Y, et al. Psychological attitudes and risk of breast cancer in Japan: a prospective study. Cancer Causes Control. 2007;18:259–67.CrossRef
33.
go back to reference Possel P, Adams E, Valentine JC. Depression as a risk factor for breast cancer: investigating methodological limitations in the literature. Cancer Causes Control. 2012;23:1223–9.CrossRef Possel P, Adams E, Valentine JC. Depression as a risk factor for breast cancer: investigating methodological limitations in the literature. Cancer Causes Control. 2012;23:1223–9.CrossRef
34.
go back to reference Wulaningsih W, Sagoo HK, Hamza M, Melvin J, Holmberg L, Garmo H, et al. Serum calcium and the risk of breast Cancer: findings from the Swedish AMORIS study and a meta-analysis of prospective studies. Int J Mol Sci. 2016;17. Wulaningsih W, Sagoo HK, Hamza M, Melvin J, Holmberg L, Garmo H, et al. Serum calcium and the risk of breast Cancer: findings from the Swedish AMORIS study and a meta-analysis of prospective studies. Int J Mol Sci. 2016;17.
35.
go back to reference Mourouti N, Kontogianni MD, Papavagelis C, Panagiotakos DB. Diet and breast cancer: a systematic review. Int J Food Sci Nutr. 2015;66:1–42.CrossRef Mourouti N, Kontogianni MD, Papavagelis C, Panagiotakos DB. Diet and breast cancer: a systematic review. Int J Food Sci Nutr. 2015;66:1–42.CrossRef
36.
go back to reference Marques O, Da SBM, Porto G, Lopes C. Iron homeostasis in breast cancer. Cancer Lett. 2014;347:1–14.CrossRef Marques O, Da SBM, Porto G, Lopes C. Iron homeostasis in breast cancer. Cancer Lett. 2014;347:1–14.CrossRef
37.
go back to reference Dai J, Hu Z, Jiang Y, Shen H, Dong J, Ma H, et al. Breast cancer risk assessment with five independent genetic variants and two risk factors in Chinese women. Breast Cancer Res. 2012;14:R17.CrossRef Dai J, Hu Z, Jiang Y, Shen H, Dong J, Ma H, et al. Breast cancer risk assessment with five independent genetic variants and two risk factors in Chinese women. Breast Cancer Res. 2012;14:R17.CrossRef
38.
go back to reference Engel C, Fischer C. Breast cancer risks and risk prediction models. Breast Care. 2015;10:7–12.CrossRef Engel C, Fischer C. Breast cancer risks and risk prediction models. Breast Care. 2015;10:7–12.CrossRef
39.
go back to reference Park B, Ma SH, Shin A, Chang MC, Choi JY, Kim S, et al. Korean risk assessment model for breast cancer risk prediction. PLoS One. 2013;8:e76736.CrossRef Park B, Ma SH, Shin A, Chang MC, Choi JY, Kim S, et al. Korean risk assessment model for breast cancer risk prediction. PLoS One. 2013;8:e76736.CrossRef
Metadata
Title
Risk prediction for breast Cancer in Han Chinese women based on a cause-specific Hazard model
Authors
Lu Wang
Liyuan Liu
Zhen Lou
Lijie Ding
Hui Guan
Fei Wang
Lixiang Yu
Yujuan Xiang
Fei Zhou
Fuzhong Xue
Zhigang Yu
Publication date
01-12-2019
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2019
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-019-5321-1

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