An epidemiologic risk prediction model for ovarian cancer in Europe: the EPIC study.
Li K., Hüsing A., Fortner RT., Tjønneland A., Hansen L., Dossus L., Chang-Claude J., Bergmann M., Steffen A., Bamia C., Trichopoulos D., Trichopoulou A., Palli D., Mattiello A., Agnoli C., Tumino R., Onland-Moret NC., Peeters PH., Bueno-de-Mesquita HB., Gram IT., Weiderpass E., Sánchez-Cantalejo E., Chirlaque MD., Duell EJ., Ardanaz E., Idahl A., Lundin E., Khaw KT., Travis RC., Merritt MA., Gunter MJ., Riboli E., Ferrari P., Terry K., Cramer D., Kaaks R.
BACKGROUND: Ovarian cancer has a high case-fatality ratio, largely due to late diagnosis. Epidemiologic risk prediction models could help identify women at increased risk who may benefit from targeted prevention measures, such as screening or chemopreventive agents. METHODS: We built an ovarian cancer risk prediction model with epidemiologic risk factors from 202,206 women in the European Prospective Investigation into Cancer and Nutrition study. RESULTS: Older age at menopause, longer duration of hormone replacement therapy, and higher body mass index were included as increasing ovarian cancer risk, whereas unilateral ovariectomy, longer duration of oral contraceptive use, and higher number of full-term pregnancies were decreasing risk. The discriminatory power (overall concordance index) of this model, as examined with five-fold cross-validation, was 0.64 (95% confidence interval (CI): 0.57, 0.70). The ratio of the expected to observed number of ovarian cancer cases occurring in the first 5 years of follow-up was 0.90 (293 out of 324, 95% CI: 0.81-1.01), in general there was no evidence for miscalibration. CONCLUSION: Our ovarian cancer risk model containing only epidemiological data showed modest discriminatory power for a Western European population. Future studies should consider adding informative biomarkers to possibly improve the predictive ability of the model.