- Volume 15 Issue 24
DOI QR Code
Refining and Validating a Two-stage and Web-based Cancer Risk Assessment Tool for Village Doctors in China
- Shen, Xing-Rong (School of Health Service Management, Anhui Medical University) ;
- Chai, Jing (School of Health Service Management, Anhui Medical University) ;
- Feng, Rui (Department of Literature Review and Analysis, Library of Anhui Medical University) ;
- Liu, Tong-Zhu (Anhui Provincial Cancer Hospital) ;
- Tong, Gui-Xian (School of Health Service Management, Anhui Medical University) ;
- Cheng, Jing (School of Health Service Management, Anhui Medical University) ;
- Li, Kai-Chun (Luan Center for Disease Prevention and Control, First Affiliated Hospital of Anhui Medical University) ;
- Xie, Shao-Yu (Luan Center for Disease Prevention and Control, First Affiliated Hospital of Anhui Medical University) ;
- Shi, Yong (Luan Center for Disease Prevention and Control, First Affiliated Hospital of Anhui Medical University) ;
- Wang, De-Bin (School of Health Service Management, Anhui Medical University)
- Published : 2015.01.22
The big gap between efficacy of population level prevention and expectations due to heterogeneity and complexity of cancer etiologic factors calls for selective yet personalized interventions based on effective risk assessment. This paper documents our research protocol aimed at refining and validating a two-stage and web-based cancer risk assessment tool, from a tentative one in use by an ongoing project, capable of identifying individuals at elevated risk for one or more types of the 80% leading cancers in rural China with adequate sensitivity and specificity and featuring low cost, easy application and cultural and technical sensitivity for farmers and village doctors. The protocol adopted a modified population-based case control design using 72, 000 non-patients as controls, 2, 200 cancer patients as cases, and another 600 patients as cases for external validation. Factors taken into account comprised 8 domains including diet and nutrition, risk behaviors, family history, precancerous diseases, related medical procedures, exposure to environment hazards, mood and feelings, physical activities and anthropologic and biologic factors. Modeling stresses explored various methodologies like empirical analysis, logistic regression, neuro-network analysis, decision theory and both internal and external validation using concordance statistics, predictive values, etc..
Supported by : Natural Science Foundation of China
- Bender R, Kuss O, Hildebrandt M, Gehrmann U (2007). Estimating adjusted NNT measures in logistic regression analysis. Stat Med, 26, 5586-95. https://doi.org/10.1002/sim.3061
- Benight CC, Bandura A (2004). Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy. Behav Res Ther, 42, 1129-48. https://doi.org/10.1016/j.brat.2003.08.008
- Caplan L (2014). Delay in breast cancer: implications for stage at diagnosis and survival. Front Public Health, 2, 87.
- Cross AJ, Boca S, Freedman ND, et al (2014). Metabolites of tobacco smoking and colorectal cancer risk. Carcinogenesis, 35, 1516-22. https://doi.org/10.1093/carcin/bgu071
- Colditz GA, Atwood KA, Emmons K, et al (2000). Harvard report on cancer prevention volume 4: harvard cancer risk index. risk index working group, harvard center for cancer prevention. Cancer Causes Control, 11, 477-88. https://doi.org/10.1023/A:1008984432272
- David MC, Ware RS, Alati R, Dower J, Donald M (2014). Assessing bias in a prospective study of diabetes that implemented substitution sampling as a recruitment strategy. J Clin Epidemiol, 67, 715-21. https://doi.org/10.1016/j.jclinepi.2013.12.004
- Eastham JA, May R, Robertson JL, Sartor O, Kattan MW (1999). Development of a nomogram that predicts the probability of a positive prostate biopsy in men with an abnormal digital rectal examination and a prostate-specific antigen between 0 and 4ng/ml. Urology, 54, 703-13.
- Emmons KM, Koch-Weser S, Atwood K, et al. (1999). A qualitative evaluation of the harvard cancer risk index. J Health Commun, 4, 181-93. https://doi.org/10.1080/108107399126904
- Feng R, Wang DB, Chai J, Cheng J, Li HP (2014). Total delay for treatment among cancer patients: a theory-guided survey in China. Asian Pac J Cancer Prev, 15, 4339-47. https://doi.org/10.7314/APJCP.2014.15.10.4339
- Feng R, Li K, Cheng J, et al (2013). Toward integrated and sustainable prevention against diabetes in rural China: study rationale and protocol of eCROPS. BMC Endocr Disord, 13, 28. https://doi.org/10.1186/1472-6823-13-28
- Freedman AN, Seminara D, Gail MH, et al (2005). Cancer risk prediction models: a workshop on development, evaluation, and application. J Natl Cancer Inst, 97, 715-23. https://doi.org/10.1093/jnci/dji128
- Gao QY, Chen HM, Chen YX, et al (2013). Folic acid prevents the initial occurrence of sporadic colorectal adenoma in Chinese older than 50 years of age: a randomized clinical trial. Cancer Prev Res, 6, 744-52. https://doi.org/10.1158/1940-6207.CAPR-13-0013
- Gupta AK, Melton LJ 3rd, Petersen GM, et al (2005). Changing trends in the incidence, stage, survival, and screen-detection of colorectal cancer: a population-based study. Clin Gastroenterol Hepatol, 3, 150-8. https://doi.org/10.1016/S1542-3565(04)00664-0
- Grundy SM, Balady GJ, Criqui MH, et al (1998). Primary prevention of coronary heart disease: guidance from Framingham: a statement for healthcare professionals from the AHA task force on risk reduction. American Heart Association. Circulaiton, 97, 1876-87. https://doi.org/10.1161/01.CIR.97.18.1876
- Gail MH, Brinton LA, Byar DP, et al (1989). Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst, 81, 1879-86. https://doi.org/10.1093/jnci/81.24.1879
- Honein-Abouhaidar GN, Kastner M, Vuong V, et al (2014). Benefits and barriers to participation in colorectal cancer screening: a protocol for a systematic review and synthesis of qualitative studies. BMJ Open, 4, 004508.
- Hady HR, Soldatow M, Lukaszewicz J, Luba M, et al (2013). Surgical treatment of malignant and benign colorectal neoplasms based on authors' clinical data. Advances Clin Experimental Med, 22, 219-27.
- He J, Chen WQ (2012). Chinese cancer registry annual report 2012. military medical science press.
- Jemal A (2012). Global burden of cancer: opportunities for prevention. Lancet, 380, 1797-99. https://doi.org/10.1016/S0140-6736(12)61688-2
- Kim DJ, Rockhill B, Colditz GA. (2004). Validation of the Harvard Cancer Risk Index: a prediction tool for individual cancer risk. J Clin Epidemiol, 57, 332-40. https://doi.org/10.1016/j.jclinepi.2003.08.013
- Lansdorp-Vogelaar I, Sharp L (2013). Cost-effectiveness of screening and treating Helicobacter pylori for gastric cancer prevention. Best Pract Res Clin Gastroenterol, 27, 933-47. https://doi.org/10.1016/j.bpg.2013.09.005
- Levano W, Miller JW, Leonard B, et al (2014). Public education and targeted outreach to underserved women through the national breast and cervical cancer early detection program. Cancer, 16, 2591-6.
- Ministry of health of the people's republic of China: China health statistic annual. peking union medical college press, 2009.
- Ozanne EM, Howe R, Omer Z, Esserman LJ (2014). Development of a personalized decision aid for breast cancer risk reduction and management. BMC Med Inform Decis Mak, 14, 4. https://doi.org/10.1186/1472-6947-14-4
- Popat K, McQueen K, Feeley TW (2013). The global burden of cancer. Best Pract Res Clin Anaesthesiol, 27, 399-408. https://doi.org/10.1016/j.bpa.2013.10.010
- Patel D, Akporobaro A, Chinyanganya N, et al. (2012). Attitudes to participation in a lung cancer screening trial: a qualitative study. Thorax, 67, 418-25. https://doi.org/10.1136/thoraxjnl-2011-200055
- Ilic M, Vlajinac H, Marinkovic J. (2014). Cigarette smoking and breast cancer: a case-control study in Serbia. Asian Pac J Cancer Prev, 14, 6643-7.
- Imperiale TF, Wagner DR, Lin CY, et al. (2003). Using risk for advanced proximal colonic neoplasia to tailor endoscopic screening for colorectal cancer. Ann Intern Med, 39, 959-65.
- Seven M, Akyuz A, Robertson LB (2014). Interventional education methods for increasing women's participation in breast cancer screening program. J Cancer Educ, [Epub ahead of print].
- Sun CQ, Chang YB, Cui LL, et al (2013). A population-based case-control study on risk factors for gastric cardia cancer in rural areas of Linzhou. Asian Pac J Cancer Prev, 14, 2897-901. https://doi.org/10.7314/APJCP.2013.14.5.2897
- Shi JF (2009). A cost-effectiveness analysis of China cervical cancer screening protocol for rural farmers. PhD thesis. China union Medical University.
- Spitz MR, Hong WK, Amos CI, et al (2007). A risk model for prediction of lung cancer. J Natl Cancer Inst, 99, 715-26. https://doi.org/10.1093/jnci/djk153
- Shimoyama T, Fukuda S, Tanaka M, Nakaji S, Munakata A (2000). Evaluation of the applicability of the gastric carcinoma risk index for intestinal type cancer in Japanese patients infected with Helicobacter pylori. Virchows Arch, 436, 585-7. https://doi.org/10.1007/s004289900179
- Tarraga Lopez PJ, Albero JS, Rodriguez-Montes JA (2014). Primary and secondary prevention of colorectal cancer. Clin Med Insights Gastroenterol, 7, 33-46.
- Trogdon JG, Ekwueme DU, Subramanian S, Crouse W (2013). Economies of scale in federally-funded state-organized public health programs: results from the national breast and cervical cancer early detection programs. Health Care Manag Sci, [Epub ahead of print].
- Wang YD, Qu LY, Guan LZ, et al (2007). Colorectal cancer screening in Beijing community: effectiveness and problems. Chinese J Primary Health Care, 10, 1586-8.
- Zhong C, Li KN, Bi JW, Wang BC. (2014). Sodium intake, salt taste and gastric cancer risk according to Helicobacter pylori infection, smoking, histological type and tumor site in China. Asian Pac J Cancer Prev, 13, 2481-4.
- Zhai LF (2012). Effectiveness and implications of colorectal cancer screening in urban communities. Chinese Primary Health Care, 26, 34-35.
- Zhang WK (1996). Control the spread of HIV/STI by incorporating prevention with treatment. J Chin AIDS/STD Pre Cont, 2, 248-53.