title: A Model to Predict the Risk of Keratinocyte Carcinomas.
abstract: Basal cell and squamous cell carcinomas of the skin are the commonest cancers in humans, yet no validated tools exist to estimate future risks of developing keratinocyte carcinomas. To develop a prediction tool, we used baseline data from a prospective cohort study (n = 38,726) in Queensland, Australia, and used data linkage to capture all surgically excised keratinocyte carcinomas arising within the cohort. Predictive factors were identified through stepwise logistic regression models. In secondary analyses, we derived separate models within strata of prior skin cancer history, age, and sex. The primary model included terms for 10 items. Factors with the strongest effects were >20 prior skin cancers excised (odds ratio 8.57, 95% confidence interval [95% CI] 6.73-10.91), >50 skin lesions destroyed (odds ratio 3.37, 95% CI 2.85-3.99), age ≥ 70 years (odds ratio 3.47, 95% CI 2.53-4.77), and fair skin color (odds ratio 1.75, 95% CI 1.42-2.15). Discrimination in the validation dataset was high (area under the receiver operator characteristic curve 0.80, 95% CI 0.79-0.81) and the model appeared well calibrated. Among those reporting no prior history of skin cancer, a similar model with 10 factors predicted keratinocyte carcinoma events with reasonable discrimination (area under the receiver operator characteristic curve 0.72, 95% CI 0.70-0.75). Algorithms using self-reported patient data have high accuracy for predicting risks of keratinocyte carcinomas.
authors.affiliation: Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia. Electronic address: david.whiteman@qimrberghofer.edu.au.
authors.forename: David C
authors.initials: DC
authors.lastname: Whiteman
authors.affiliation: Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
authors.forename: Bridie S
authors.initials: BS
authors.lastname: Thompson
authors.affiliation: Department of Medicine and Dan L. Duncan Cancer Center, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: Aaron P
authors.initials: AP
authors.lastname: Thrift
authors.affiliation: Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
authors.forename: Maria-Celia
authors.initials: MC
authors.lastname: Hughes
authors.affiliation: Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia; School of Population Health, The University of Queensland, Herston, Queensland, Australia.
authors.forename: Chiho
authors.initials: C
authors.lastname: Muranushi
authors.affiliation: Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Neale
authors.affiliation: Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia; Cancer Research UK Manchester Institute and Institute of Inflammation and Repair, University of Manchester, Manchester, UK.
authors.forename: Adele C
authors.initials: AC
authors.lastname: Green
authors.affiliation: Population Health Department, QIMR Berghofer Medical Research Institute, Herston, Queensland, Australia.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Olsen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D019540:Area Under Curve; D001707:Biopsy, Needle; D002280:Basal Cell Carcinoma / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D015994:Incidence; D015603:Keratinocytes / Q000473:pathology*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D011446:Prospective Studies; D011793:Queensland; D015203:Reproducibility of Results; D018570:Risk Assessment; D017678:Sex Distribution; D012878:Skin Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000503:physiopathology