Development and validation of a questionnaire-based risk scoring system to identify individuals at high risk for gastric cancer in Chinese populations  

作　　者：Ren Zhou Hongchen Zheng Mengfei Liu Zhen Liu Chuanhai Guo Hongrui Tian Fangfang Liu Ying Liu Yaqi Pan Huanyu Chen Zhe Hu Hong Cai Zhonghu He Yang Ke 

机构地区：[1]Key Laboratory of Carcinogenesis and Translational Research(Ministry of Education/Beijing),Laboratory of Genetics,Peking University Cancer Hospital&Institute,Beijing 100142,China

出　　处：《Chinese Journal of Cancer Research》2021年第6期649-658,共10页中国癌症研究（英文版）

基　　金：supported by the National Science&Technology Fundamental Resources Investigation Program of China(No.2019FY101102);the National Natural Science Foundation of China(No.82073626,81773501);the National Key R&D Program of China(No.2016YFC0901404);the Beijing-Tianjin-Hebei Basic Research Cooperation Project(No.J200016);the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority(No.XXZ0204);the Beijing Hospitals Authority Youth Programme(No.QML20201101);Sanming Project of Shenzhen(No.SZSM201612061);the Beijing Nova Program(No.Z201100006820093)。

摘　　要：Objective:This study aimed to develop and validate a risk scoring system to identify high-risk individuals carrying malignant lesions in stomach for tailored gastric cancer screening.Methods:A gastric cancer risk scoring system(GC-RSS)was developed based on questionnaire-based predictors for gastric cancer derived from systematic literature review.To assess the capability of this system for discrimination,risk scores for 8,214 and 7,235 outpatient subjects accepting endoscopic examination in two endoscopy centers,and 32,630 participants in a community-based cohort in China were calculated to plot receiver operating characteristic curves and generate area under the curve(AUC).To evaluate the performance of GC-RSS,the screening proportion,sensitivity and detection rate ratio compared to universal screening were used under different risk score cutoff values.Results:GC-RSS comprised nine predictors including advanced age,male gender,low body mass index(<18.5 kg/m^(2)),family history of gastric cancer,cigarette smoking,consumption of alcohol,preference for salty food,irregularity of meals and consumption of preserved food.This tool performed well in determining the risk of malignant gastric lesions with AUCs of 0.763,0.706 and 0.696 in three validation sets.When subjects with risk scores≥5 were evaluated with endoscopy,nearly 50%of these endoscopies could be saved with a detection rate of over 1.5 times achieved.When the cutoff was set at 8,only about 10%of subjects with the highest risk would be offered endoscopy,and detection rates for gastric cancer could be increased 2-4 fold compared to universal screening.Conclusions:An effective questionnaire-based GC-RSS was developed and validated.This tool may play an important role in establishing a tailored screening strategy for gastric cancer in China.

关 键 词：Cancer screening external validation gastric cancer risk scoring system 

分 类 号：R735.2[医药卫生—肿瘤]