A Validated Clinical Risk Prediction Model for Lung Cancer in Smokers of All Ages and Exposure Types: A HUNT Study

Maria Markaki, Ioannis Tsamardinos, Arnulf Langhammer, Vincenzo Lagani, Kristian Hveem, Oluf Dimitri Røe

Research output: Contribution to journalArticlepeer-review

46 Scopus citations

Abstract

Lung cancer causes >1·6 million deaths annually, with early diagnosis being paramount to effective treatment. Here we present a validated risk assessment model for lung cancer screening. The prospective HUNT2 population study in Norway examined 65,237 people aged >20 years in 1995–97. After a median of 15·2 years, 583 lung cancer cases had been diagnosed; 552 (94·7%) ever-smokers and 31 (5·3%) never-smokers. We performed multivariable analyses of 36 candidate risk predictors, using multiple imputation of missing data and backwards feature selection with Cox regression. The resulting model was validated in an independent Norwegian prospective dataset of 45,341 ever-smokers, in which 675 lung cancers had been diagnosed after a median follow-up of 11·6 years. Our final HUNT Lung Cancer Model included age, pack-years, smoking intensity, years since smoking cessation, body mass index, daily cough, and hours of daily indoors exposure to smoke. External validation showed a 0·879 concordance index (95% CI [0·866–0·891]) with an area under the curve of 0·87 (95% CI [0·85–0·89]) within 6 years. Only 22% of ever-smokers would need screening to identify 81·85% of all lung cancers within 6 years. Our model of seven variables is simple, accurate, and useful for screening selection.
Original languageEnglish (US)
Pages (from-to)36-46
Number of pages11
JournalEBioMedicine
Volume31
DOIs
StatePublished - May 1 2018
Externally publishedYes

Bibliographical note

Generated from Scopus record by KAUST IRTS on 2023-09-23

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology
  • General Medicine

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