Individual risk of cutaneous melanoma in New Zealand: developing a clinical prediction aid

BMC Cancer

Brian Cox¹  Claire Cameron²  Mary Jane Sneyd¹ 

[1]Hugh Adam Cancer Epidemiology Unit, Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 56, Dunedin 9054, New Zealand

[2]Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, P.O. Box 913, Dunedin 9054, New Zealand

关键词: Risk assessment;    Logistic model;    Risk prediction;    Absolute risk;    Melanoma;   

Others  :  858799
DOI  :  10.1186/1471-2407-14-359

 received in 2013-09-05, accepted in 2014-05-19,  发布年份 2014

【 摘 要 】

Background

New Zealand and Australia have the highest melanoma incidence rates worldwide. In New Zealand, both the incidence and thickness have been increasing. Clinical decisions require accurate risk prediction but a simple list of genetic, phenotypic and behavioural risk factors is inadequate to estimate individual risk as the risk factors for melanoma have complex interactions. In order to offer tailored clinical management strategies, we developed a New Zealand prediction model to estimate individual 5-year absolute risk of melanoma.

Methods

A population-based case–control study (368 cases and 270 controls) of melanoma risk factors provided estimates of relative risks for fair-skinned New Zealanders aged 20–79 years. Model selection techniques and multivariate logistic regression were used to determine the important predictors. The relative risks for predictors were combined with baseline melanoma incidence rates and non-melanoma mortality rates to calculate individual probabilities of developing melanoma within 5 years.

Results

For women, the best model included skin colour, number of moles > =5 mm on the right arm, having a 1st degree relative with large moles, and a personal history of non-melanoma skin cancer (NMSC). The model correctly classified 68% of participants; the C-statistic was 0.74. For men, the best model included age, place of occupation up to age 18 years, number of moles > =5 mm on the right arm, birthplace, and a history of NMSC. The model correctly classified 67% of cases; the C-statistic was 0.71.

Conclusions

We have developed the first New Zealand risk prediction model that calculates individual absolute 5-year risk of melanoma. This model will aid physicians to identify individuals at high risk, allowing them to individually target surveillance and other management strategies, and thereby reduce the high melanoma burden in New Zealand.

【 授权许可】

   
2014 Sneyd et al.; licensee BioMed Central Ltd.

【 图 表 】

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