Risk Prediction Model for Esophageal Cancer Among General Population: A Systematic Review

Abstract

Objective: The risk prediction model is an effective tool for risk stratification and is expected to play an important role in the early detection and prevention of esophageal cancer. This study sought to summarize the available evidence of esophageal cancer risk predictions models and provide references for their development, validation, and application.Methods: We searched PubMed, EMBASE, and Cochrane Library databases for original articles published in English up to October 22, 2021. Studies that developed or validated a risk prediction model of esophageal cancer and its precancerous lesions were included. Two reviewers independently extracted study characteristics including predictors, model performance and methodology, and assessed risk of bias and applicability with PROBAST (Prediction model Risk Of Bias Assessment Tool).Results: A total of 20 studies including 30 original models were identified. The median area under the receiver operating characteristic curve of risk prediction models was 0.78, ranging from 0.68 to 0.94. Age, smoking, body mass index, sex, upper gastrointestinal symptoms, and family history were the most commonly included predictors. None of the models were assessed as low risk of bias based on PROBST. The major methodological deficiencies were inappropriate date sources, inconsistent definition of predictors and outcomes, and the insufficient number of participants with the outcome.Conclusions: This study systematically reviewed available evidence on risk prediction models for esophageal cancer in general populations. The findings indicate a high risk of bias due to several methodological pitfalls in model development and validation, which limit their application in practice.

Tobacco Smoking and Gastrointestinal Cancer Risk

“…Former smokers surviving a lung or head and neck cancer should be surveilled endoscopically for a second primary ESCC [16]. Risk prediction models for esophageal cancer among the general population and biomarkers for early detection are being evaluated [18, 19].…”

Development and Validation of Esophageal Squamous Cell Carcinoma Risk Prediction Models Based on an Endoscopic Screening Program

“… 11 Existing prediction models (eTable 1 in Supplement 1 ) were limited and have many defects. 16 , 18 , 19 Prediction models based on case-control studies have low evidence quality, 20 , 21 , 22 , 23 and cohort-based models rarely perform external validation, tend to be based on questionnaire data, and do not consider endoscopic-related risk factors. 24 , 25 Therefore, this report aims to establish and validate ESCC prediction models for the follow-up stage of esophageal cancer screening and to optimize the esophageal cancer screening program.…”

“…The development direction of esophageal cancer screening is precision, individualization, and risk prediction based; therefore, the prediction model plays an important role . Existing prediction models (eTable 1 in Supplement 1) were limited and have many defects . Prediction models based on case-control studies have low evidence quality, and cohort-based models rarely perform external validation, tend to be based on questionnaire data, and do not consider endoscopic-related risk factors .…”

lncRNA SSTR5-AS1 Predicts Poor Prognosis and Contributes to the Progression of Esophageal Cancer

“…More than 300,000 people are diagnosed with esophageal cancer (ESCA) every year, making it one of the most common malignant tumors of the upper gastrointestinal tract and a serious threat to human health [ 1 , 2 ]. Recent researches have indicated that a combination of factors, such as unhealthy lifestyle choices, exposure to carcinogens, underlying disorders, and genetics, has a role in the development of esophageal cancer [ 3 , 4 ]. There are a number of risk factors that can enhance an individual's susceptibility to ESCA.…”