Development and internal validation of a multifactorial risk prediction model for gallbladder cancer in a high‐incidence country
Journal
International Journal of Cancer
ISSN
0020-7136
1097-0215
Date Issued
2023
Author(s)
Felix Boekstegers
Dominique Scherer
Carol Barahona Ponce
Katherine Marcelain
Valentina Gárate‐Calderón
Melanie Waldenberger
Erik Morales
Armando Rojas
César Munoz
Javier Retamales
Gonzalo de Toro
Olga Barajas
María Teresa Rivera
Analía Cortés
Denisse Loader
Javiera Saavedra
Lorena Gutiérrez
Alejandro Ortega
Maria Enriqueta Bertrán
Leonardo Bartolotti
Fernando Gabler
Mónica Campos
Juan Alvarado
Fabricio Moisán
Loreto Spencer
Bruno Nervi
Héctor Losada
Mauricio Almau
Plinio Fernández
Jordi Olloquequi
Macarena Fuentes‐Guajardo
Rolando Gonzalez‐Jose
Maria Cátira Bortolini
Victor Acuña‐Alonzo
Carla Gallo
Andres Ruiz Linares
Francisco Rothhammer
Justo Lorenzo Bermejo
Type
Resource Types::text::journal::journal article
URL Institutional Repository
Abstract
<jats:title>Abstract</jats:title><jats:p>Since 2006, Chile has been implementing a gallbladder cancer (GBC) prevention program based on prophylactic cholecystectomy for gallstone patients aged 35 to 49 years. The effectiveness of this prevention program has not yet been comprehensively evaluated. We conducted a retrospective study of 473 Chilean GBC patients and 2137 population‐based controls to develop and internally validate three GBC risk prediction models. The Baseline Model accounted for gallstones while adjusting for sex and birth year. Enhanced Model I also included the non‐genetic risk factors: body mass index, educational level, Mapuche surnames, number of children and family history of GBC. Enhanced Model II further included Mapuche ancestry and the genotype for rs17209837. Multiple Cox regression was applied to assess the predictive performance, quantified by the area under the precision‐recall curve (AUC‐PRC) and the number of cholecystectomies needed (NCN) to prevent one case of GBC at age 70 years. The AUC‐PRC for the Baseline Model (0.44%, 95%CI 0.42‐0.46) increased by 0.22 (95%CI 0.15‐0.29) when non‐genetic factors were included, and by 0.25 (95%CI 0.20‐0.30) when incorporating non‐genetic and genetic factors. The overall NCN for Chileans with gallstones (115, 95%CI 104‐131) decreased to 92 (95%CI 60‐128) for Chileans with a higher risk than the median according to Enhanced Model I, and to 80 (95%CI 59‐110) according to Enhanced Model II. In conclusion, age, sex and gallstones are strong risk factors for GBC, but consideration of other non‐genetic factors and individual genotype data improves risk prediction and may optimize allocation of financial resources and surgical capacity.</jats:p>
Cite this document
Boekstegers, F., Scherer, D., Barahona Ponce, C., Marcelain, K., Gárate‐Calderón, V., Waldenberger, M., Morales, E., Rojas, A., Munoz, C., Retamales, J., De Toro, G., Barajas, O., Rivera, M. T., Cortés, A., Loader, D., Saavedra, J., Gutiérrez, L., Ortega, A., Bertrán, M. E., … Lorenzo Bermejo, J. (2023). Development and internal validation of a multifactorial risk prediction model for gallbladder cancer in a high‐incidence country. International Journal of Cancer, 153(6), 1151-1161. https://doi.org/10.1002/ijc.34607
Subjects
cholecystectomy
;
gallbladder cancer
;
gallstones
;
native american ancestry
;
non-genetic and genetic risk factors
;
risk prediction
;
aged
;
case-control studies
;
child
;
gallbladder neoplasms
;
gallstones
;
humans
;
incidence
;
retrospective studies
;
risk factors
;
adult
;
age
;
area under the curve
;
article
;
body mass
;
cancer incidence
;
cancer patient
;
cancer risk
;
chile
;
chilean
;
cholecystectomy
;
controlled study
;
educational status
;
family history
;
female
;
gallbladder cancer
;
gallstone
;
genotype
;
human
;
major clinical study
;
male
;
mapuche (people)
;
prediction
;
proportional hazards model
;
retrospective study
;
sex
;
aged
;
case control study
;
child
;
complication
;
gallbladder tumor
;
gallstone
;
genetics
;
incidence
;
risk factor