Endometrial cancer risk prediction including serum-based biomarkers: Results from the EPIC cohort

Endometrial cancer risk prediction models including lifestyle, anthropometric, and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case-con...

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Main Authors: Fortner, R, Hüsing, A, Kühn, T, Konar, M, Overvad, K, Tjønneland, A, Hansen, L, Boutron-Ruault, M, Severi, G, Fournier, A, Boeing, H, Trichopoulou, A, Benetou, V, Orfanos, P, Masala, G, Agnoli, C, Mattiello, A, Tumino, R, Sacerdote, C, Bueno-de-Mesquita, H, Peeters, P, Weiderpass, E, Gram, I, Gavrilyuk, O, Quirós, J, Huerta, J, Ardanaz, E, Larrañaga, N, Lujan-Barroso, L, Sánchez-Cantalejo, E, Butt, S, Borgquist, S, Idahl, A, Lundin, E, Khaw, K, Allen, N, Rinaldi, S, Dossus, L, Gunter, M, Merritt, M, Tzoulaki, I, Riboli, E, Kaaks, R
Format: Journal article
Language:English
Published: Wiley 2016
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author Fortner, R
Hüsing, A
Kühn, T
Konar, M
Overvad, K
Tjønneland, A
Hansen, L
Boutron-Ruault, M
Severi, G
Fournier, A
Boeing, H
Trichopoulou, A
Benetou, V
Orfanos, P
Masala, G
Agnoli, C
Mattiello, A
Tumino, R
Sacerdote, C
Bueno-de-Mesquita, H
Peeters, P
Weiderpass, E
Gram, I
Gavrilyuk, O
Quirós, J
Huerta, J
Ardanaz, E
Larrañaga, N
Lujan-Barroso, L
Sánchez-Cantalejo, E
Butt, S
Borgquist, S
Idahl, A
Lundin, E
Khaw, K
Allen, N
Rinaldi, S
Dossus, L
Gunter, M
Merritt, M
Tzoulaki, I
Riboli, E
Kaaks, R
author_facet Fortner, R
Hüsing, A
Kühn, T
Konar, M
Overvad, K
Tjønneland, A
Hansen, L
Boutron-Ruault, M
Severi, G
Fournier, A
Boeing, H
Trichopoulou, A
Benetou, V
Orfanos, P
Masala, G
Agnoli, C
Mattiello, A
Tumino, R
Sacerdote, C
Bueno-de-Mesquita, H
Peeters, P
Weiderpass, E
Gram, I
Gavrilyuk, O
Quirós, J
Huerta, J
Ardanaz, E
Larrañaga, N
Lujan-Barroso, L
Sánchez-Cantalejo, E
Butt, S
Borgquist, S
Idahl, A
Lundin, E
Khaw, K
Allen, N
Rinaldi, S
Dossus, L
Gunter, M
Merritt, M
Tzoulaki, I
Riboli, E
Kaaks, R
author_sort Fortner, R
collection OXFORD
description Endometrial cancer risk prediction models including lifestyle, anthropometric, and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, we investigated the improvement in discrimination gained by adding serum biomarker concentrations to risk estimates derived from an existing risk prediction model based on epidemiologic factors. Serum concentrations of sex steroid hormones, metabolic markers, growth factors, adipokines, and cytokines were evaluated in a step-wise backward selection process; biomarkers were retained at p<0.157 indicating improvement in the Akaike information criterion (AIC). Improvement in discrimination was assessed using the C-statistic for all biomarkers alone, and change in C-statistic from addition of biomarkers to preexisting absolute risk estimates. We used internal validation with bootstrapping (1000-fold) to adjust for over-fitting. Adiponectin, estrone, interleukin-1 receptor antagonist, tumor necrosis factor-alpha, and triglycerides were selected into the model. After accounting for over-fitting, discrimination was improved by 2.0 percentage points when all evaluated biomarkers were included and 1.7 percentage points in the model including the selected biomarkers. Models including etiologic markers on independent pathways and genetic markers may further improve discrimination.
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spelling oxford-uuid:4e5e4364-deee-42c7-ac2e-fa48296830622022-03-26T16:00:51ZEndometrial cancer risk prediction including serum-based biomarkers: Results from the EPIC cohortJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:4e5e4364-deee-42c7-ac2e-fa4829683062EnglishSymplectic Elements at OxfordWiley2016Fortner, RHüsing, AKühn, TKonar, MOvervad, KTjønneland, AHansen, LBoutron-Ruault, MSeveri, GFournier, ABoeing, HTrichopoulou, ABenetou, VOrfanos, PMasala, GAgnoli, CMattiello, ATumino, RSacerdote, CBueno-de-Mesquita, HPeeters, PWeiderpass, EGram, IGavrilyuk, OQuirós, JHuerta, JArdanaz, ELarrañaga, NLujan-Barroso, LSánchez-Cantalejo, EButt, SBorgquist, SIdahl, ALundin, EKhaw, KAllen, NRinaldi, SDossus, LGunter, MMerritt, MTzoulaki, IRiboli, EKaaks, REndometrial cancer risk prediction models including lifestyle, anthropometric, and reproductive factors have limited discrimination. Adding biomarker data to these models may improve predictive capacity; to our knowledge, this has not been investigated for endometrial cancer. Using a nested case-control study within the European Prospective Investigation into Cancer and Nutrition (EPIC) cohort, we investigated the improvement in discrimination gained by adding serum biomarker concentrations to risk estimates derived from an existing risk prediction model based on epidemiologic factors. Serum concentrations of sex steroid hormones, metabolic markers, growth factors, adipokines, and cytokines were evaluated in a step-wise backward selection process; biomarkers were retained at p<0.157 indicating improvement in the Akaike information criterion (AIC). Improvement in discrimination was assessed using the C-statistic for all biomarkers alone, and change in C-statistic from addition of biomarkers to preexisting absolute risk estimates. We used internal validation with bootstrapping (1000-fold) to adjust for over-fitting. Adiponectin, estrone, interleukin-1 receptor antagonist, tumor necrosis factor-alpha, and triglycerides were selected into the model. After accounting for over-fitting, discrimination was improved by 2.0 percentage points when all evaluated biomarkers were included and 1.7 percentage points in the model including the selected biomarkers. Models including etiologic markers on independent pathways and genetic markers may further improve discrimination.
spellingShingle Fortner, R
Hüsing, A
Kühn, T
Konar, M
Overvad, K
Tjønneland, A
Hansen, L
Boutron-Ruault, M
Severi, G
Fournier, A
Boeing, H
Trichopoulou, A
Benetou, V
Orfanos, P
Masala, G
Agnoli, C
Mattiello, A
Tumino, R
Sacerdote, C
Bueno-de-Mesquita, H
Peeters, P
Weiderpass, E
Gram, I
Gavrilyuk, O
Quirós, J
Huerta, J
Ardanaz, E
Larrañaga, N
Lujan-Barroso, L
Sánchez-Cantalejo, E
Butt, S
Borgquist, S
Idahl, A
Lundin, E
Khaw, K
Allen, N
Rinaldi, S
Dossus, L
Gunter, M
Merritt, M
Tzoulaki, I
Riboli, E
Kaaks, R
Endometrial cancer risk prediction including serum-based biomarkers: Results from the EPIC cohort
title Endometrial cancer risk prediction including serum-based biomarkers: Results from the EPIC cohort
title_full Endometrial cancer risk prediction including serum-based biomarkers: Results from the EPIC cohort
title_fullStr Endometrial cancer risk prediction including serum-based biomarkers: Results from the EPIC cohort
title_full_unstemmed Endometrial cancer risk prediction including serum-based biomarkers: Results from the EPIC cohort
title_short Endometrial cancer risk prediction including serum-based biomarkers: Results from the EPIC cohort
title_sort endometrial cancer risk prediction including serum based biomarkers results from the epic cohort
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