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dc.contributor.authorXie, Shao-Hua
dc.contributor.authorNess-Jensen, Eivind
dc.contributor.authorMedefelt, Nils
dc.contributor.authorLagergren, Jesper
dc.identifier.citationAmerican Journal of Gastroenterology. 2018, 113 829-835.nb_NO
dc.description.abstractOBJECTIVES: Unselected screening for oesophageal adenocarcinoma (OAC) is not justified due to the low absolute risk in the general population. This study aimed to evaluate a risk prediction model in identifying high-risk individuals who might be considered for targeted screening. METHODS: A population-based cohort of 62,576 participants was recruited in 1995–1997 in Nord-Trøndelag County, Norway (HUNT) and followed up until 31 December 2015. A model for predicting individuals’ absolute risk of OAC was developed using competing-risk regression. The Lorenz curve was used to assess the concentration of OAC patients in high-risk individuals and the feasibility of targeted screening based on individual risk assessment. RESULTS: During 1,085,137 person-years of follow-up, 29 incident cases of OAC occurred. The model included risk factors for OAC, in which male sex, older age, gastro-oesophageal reflux symptoms, obesity, and tobacco smoking predicted higher risk of OAC. The area under the receiver operating characteristic curve for 10-year risk of OAC was 0.71 (95% confidence interval 0.57–0.85) and for 15-year risk was 0.84 (95% confidence interval 0.76–0.91) after 10-fold cross-validation, with good agreements between observed and predicted risks. The Lorenz curve indicated that 33% of all OAC cases would have occurred in the 5% of the population with the highest risks within 15 years, and 61% of all cases in the top 10% of the population. CONCLUSIONS: Individual risk assessment based on known risk factors for OAC has the potential to identify a selected high-risk group of individuals who may benefit from screening for early detection.nb_NO
dc.publisherSpringer Naturenb_NO
dc.rightsAttribution-NonCommercial-NoDerivatives 4.0 Internasjonal*
dc.titleAssessing the feasibility of targeted screening for esophageal adenocarcinoma based on individual risk assessment in a population-based cohort study in Norway (The HUNT Study)nb_NO
dc.typeJournal articlenb_NO
dc.typePeer reviewednb_NO
dc.source.journalAmerican Journal of Gastroenterologynb_NO
dc.description.localcode© The Author(s) 2018nb_NO
cristin.unitnameHelseundersøkelsen i Nord-Trøndelag

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Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal
Except where otherwise noted, this item's license is described as Attribution-NonCommercial-NoDerivatives 4.0 Internasjonal