%0 Journal Article
%A Hüsing, Anika
%A Dossus, Laure
%A Ferrari, Pietro
%A Tjønneland, Anne
%A Hansen, Louise
%A Fagherazzi, Guy
%A Baglietto, Laura
%A Schock, Helena
%A Chang-Claude, Jenny
%A Boeing, Heiner
%A Steffen, Annika
%A Trichopoulou, Antonia
%A Bamia, Christina
%A Katsoulis, Michalis
%A Krogh, Vittorio
%A Palli, Domenico
%A Panico, Salvatore
%A Onland-Moret, N Charlotte
%A Peeters, Petra H
%A Bueno-de-Mesquita, H Bas
%A Weiderpass, Elisabete
%A Gram, Inger T
%A Ardanaz, Eva
%A Obón-Santacana, Mireia
%A Navarro, Carmen
%A Sánchez-Cantalejo, Emilio
%A Etxezarreta, Nerea
%A Allen, Naomi E
%A Khaw, Kay Tee
%A Wareham, Nick
%A Rinaldi, Sabina
%A Romieu, Isabelle
%A Merritt, Melissa A
%A Gunter, Marc
%A Riboli, Elio
%A Kaaks, Rudolf
%T An epidemiological model for prediction of endometrial cancer risk in Europe.
%D 2015
%U http://hdl.handle.net/10668/9816
%X Endometrial cancer (EC) is the fourth most frequent cancer in women in Europe, and as its incidence is increasing, prevention strategies gain further pertinence. Risk prediction models can be a useful tool for identifying women likely to benefit from targeted prevention measures. On the basis of data from 201,811 women (mostly aged 30-65 years) including 855 incident EC cases from eight countries in the European Prospective Investigation into Cancer and Nutrition cohort, a model to predict EC was developed. A step-wise model selection process was used to select confirmed predictive epidemiologic risk factors. Piece-wise constant hazard rates in 5-year age-intervals were estimated in a cause-specific competing risks model, five-fold-cross-validation was applied for internal validation. Risk factors included in the risk prediction model were body-mass index (BMI), menopausal status, age at menarche and at menopause, oral contraceptive use, overall and by different BMI categories and overall duration of use, parity, age at first full-term pregnancy, duration of menopausal hormone therapy and smoking status (specific for pre, peri- and post-menopausal women). These variables improved the discriminating capacity to predict risk over 5 years from 71% for a model based on age alone to 77% (overall C statistic), and the model was well-calibrated (ratio of expected to observed cases = 0.99). Our model could be used for the identification of women at increased risk of EC in Western Europe. To achieve an EC-risk model with general validity, a large-scale cohort-consortium approach would be needed to assess and adjust for population variation.
%K Endometrial cancer
%K Epidemiology
%K Prevention
%K Risk model
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