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Development and internal validation of a multifactorial riskprediction model for gallbladder cancer in a high-incidencecountry

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dc.contributor.authorBoekstegers, Felix
dc.contributor.authorScherer, Dominique
dc.contributor.authorBarahona, Carol
dc.contributor.authorMarcelain, Katherine
dc.contributor.authorGárate, Valentina
dc.contributor.authorWaldenberge, Melanie
dc.contributor.authorMorales, Erik
dc.contributor.authorRojas, Armando
dc.contributor.authorMunoz, César
dc.contributor.authorRetamales, Javier
dc.contributor.authorDe Toro, Gonzalo
dc.contributor.authorBarajas, Olga
dc.contributor.authorRivera, María
dc.contributor.authorCortés, Analía
dc.contributor.authorLoader, Denisse
dc.contributor.authorSaavedra, Javiera
dc.contributor.authorGutiérrez, Lorena
dc.contributor.authorOrtega, Alejandro
dc.contributor.authorBertrán, Maria
dc.contributor.authorBartolotti, Leonardo
dc.contributor.authorGabler, Fernando
dc.contributor.authorCampos, Monica
dc.contributor.authorAlvarado, Juan
dc.contributor.authorMoisán, Fabricio
dc.contributor.authorSpencer, Loreto
dc.contributor.authorNervi, Bruno
dc.contributor.authorCarvajal-Hausdorf, Daniel
dc.contributor.authorLosada, Héctor
dc.contributor.authorAlmau, Mauricio
dc.contributor.authorFernández, Plinio
dc.contributor.authorOlloquequi, Jordi
dc.contributor.authorFuentes, Macarena
dc.contributor.authorGonzalez, Rolando
dc.contributor.authorBortolin, Maria
dc.contributor.authorAcuña, Victor
dc.contributor.authorGallo, Carla
dc.contributor.authorRuiz, Andres
dc.contributor.authorRothhamme, Francisco
dc.contributor.authorBermejo, Justo
dc.date.accessioned2024-05-13T16:23:27Z
dc.date.available2024-05-13T16:23:27Z
dc.date.issued2023
dc.description.abstractSince 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.
dc.description.versionAceptada
dc.identifier.citationBoekstegers 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 MT, Cortés A, Loader D, Saavedra J, Gutiérrez L, Ortega A, Bertrán ME, Bartolotti L, Gabler F, Campos M, Alvarado J, Moisán F, Spencer L, Nervi B, Carvajal-Hausdorf D, Losada H, Almau M, Fernández P, Olloquequi J, Fuentes-Guajardo M, Gonzalez-Jose R, Bortolini MC, Acuña-Alonzo V, Gallo C, Linares AR, Rothhammer F, Lorenzo Bermejo J. Development and internal validation of a multifactorial risk prediction model for gallbladder cancer in a high-incidence country. Int J Cancer. 2023 Sep 15;153(6):1151-1161. doi: 10.1002/ijc.34607
dc.identifier.doihttps://doi.org/10.1002/ijc.34607
dc.identifier.urihttps://hdl.handle.net/11447/8738
dc.language.isoen
dc.subjectCholecystectomy
dc.subjectGallbladder cancer
dc.subjectGallstones
dc.subjectNative American ancestry
dc.subjectNon-genetic and genetic risk factors
dc.subjectRisk prediction
dc.titleDevelopment and internal validation of a multifactorial riskprediction model for gallbladder cancer in a high-incidencecountry
dc.typeArticle
dcterms.accessRightsAcceso Abierto
dcterms.sourceInternational journal of cancer
dspace.entity.typePublication
relation.isAuthorOfPublication8e2ee03b-003a-4e24-b577-290a5cd449c1
relation.isAuthorOfPublication.latestForDiscovery8e2ee03b-003a-4e24-b577-290a5cd449c1

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