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

Alison P Klein, Sara Lindström, Julie B Mendelsohn, Emily Steplowski, Alan A Arslan, H Bas Bueno- de-Mesquita, Charles S Fuchs, Steven Gallinger, Myron Gross, Kathy Helzlsouer, Elizabeth A Holly, Eric J Jacobs, Andrea LaCroix, Donghui Li, Margaret T Mandelson, Sara H Olson, Gloria M Petersen, Harvey A Risch, Rachael Z Stolzenberg-Solomon, Wei Zheng, Laufey Amundadottir, 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 Elena, J Michael Gaziano, Edward L Giovannucci, Michael Goggins, Göran Hallmans, Manal 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 and Peter Kraft

PLOS ONE, 2013, vol. 8, issue 9, 1-10

Abstract: 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/m2) (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 to identify a group of individuals at higher than average risk of pancreatic cancer, the immediate clinical utility of our model is limited. However, a risk model can increase awareness of the various risk factors for pancreatic cancer, including modifiable behaviors.

Date: 2013
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0072311

DOI: 10.1371/journal.pone.0072311

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