Development of a prediction model for 10-year risk of hepatocellular carcinoma in middle-aged Japanese: the Japan Public Health Center-based Prospective Study Cohort II.
OBJECTIVE
The purpose of the present study was to develop a risk estimation model for the 10-year risk of hepatocellular carcinoma (HCC) that could be easily used in a general population to aid in the prevention of HCC.


METHODS
Our prediction model was derived from data obtained on 17,654 Japanese aged 40 to 69 years who participated in health checkups (follow-up: 1993-2006). Cox proportional hazards regression was applied to obtain coefficients for each predictor.


RESULTS
During follow-up, a total of 104 cases of HCC were newly diagnosed. After checking the model fit, we incorporated age, sex, alcohol consumption, body mass index, diabetes, coffee consumption, and hepatitis B and C virus infection into the prediction model. The model showed satisfactory discrimination (Harrell's c-index=0.94) and was well calibrated (the overall observed/expected ratio=1.03, 95% confidence interval=0.83-1.29). We also developed a simple risk scoring system. Those subjects with total scores of 17 or more under this system (score range: -1 to 19) had an estimated 10-year HCC risk of over 90%; those with 4 points or less had an estimated risk of less than 0.1%.


CONCLUSIONS
We developed a simple 10-year risk prediction model for HCC in the Japanese general population as a public education tool.
Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, 16-2 Onogawa, Tsukuba, Ibaraki 305-8506, Japan. tmichikawa@nies.go.jp
Takehiro
T
Michikawa
Manami
M
Inoue
Norie
N
Sawada
Motoki
M
Iwasaki
Yasuhito
Y
Tanaka
Taichi
T
Shimazu
Shizuka
S
Sasazuki
Taiki
T
Yamaji
Masashi
M
Mizokami
Shoichiro
S
Tsugane
D000328:Adult; D017677:Age Distribution; D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000209:etiology*; D003069:Coffee; D015331:Cohort Studies; D004327:Drinking Behavior; D005260:Female; D005500:Follow-Up Studies; D007722:Health Knowledge, Attitudes, Practice; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011446:Prospective Studies; D018570:Risk Assessment / Q000379:methods*; D017678:Sex Distribution; D011795:Surveys and Questionnaires
D003069:Coffee