Health risk appraisal models for mass screening of esophageal cancer in Japanese men

Tetsuji Yokoyama, Akira Yokoyama, Yoshiya Kumagai, Tai Omori, Hoichi Kato, Hiroyasu Igaki, Toshimasa Tsujinaka, Manabu Muto, Masako Yokoyama, Hiroshi Watanabe

Research output: Contribution to journalArticle

27 Citations (Scopus)

Abstract

Background: Because early squamous cell carcinoma (SCC) of the esophagus is detectable by endoscopic esophageal iodine staining with high accuracy and is easily treated by endoscopic mucosectomy, it is important to develop efficient methods for screening candidates for the endoscopic examination. Inactive aldehyde dehydrogenase-2 (ALDH2) is a very strong risk factor for esophageal SCC in alcohol drinkers and thus may be suitable as a screening tool. Purpose: To assess the performance of health risk appraisal (HRA) models in screening for esophageal SCC in the Japanese male population. Methods: Two types of HRA models were developed based on our previous case-control study, which included assessment of ALDH2 activity and selected risk factors (HRA-G and HRA-F: activities of ALDH2 assessed by genotype and questionnaire for alcohol flushing, respectively). Each individual's risk of esophageal SCC was calculated quantitatively as a risk score. The sensitivity and specificity of the HRA models at various cutoff values of risk score was estimated by a leave-one-out cross-validation. The positive predictive value was estimated assuming the prevalence of esophageal SCC in the whole population to be 0.17% or 0.39% according to literatures. Results: When individuals ranked in the top 10% of the HRA-F risk score was screened, the sensitivity was 57.9% and positive predictive value was 0.93% or 2.12% according to the above assumptions, respectively. The sensitivity was slightly better by the HRA-G model than by the HRA-F model. Conclusion: The HRA models may provide an important approach to early intervention strategies to control esophageal SCC in Japanese men.

Original languageEnglish
Pages (from-to)2846-2854
Number of pages9
JournalCancer Epidemiology Biomarkers and Prevention
Volume17
Issue number10
DOIs
Publication statusPublished - 2008 Oct

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Health Status Indicators
Mass Screening
Esophageal Neoplasms
Aldehyde Dehydrogenase
Alcohols
Iodine
Population
Esophagus
Case-Control Studies
Squamous Cell Carcinoma
Genotype
Esophageal Squamous Cell Carcinoma
Staining and Labeling

ASJC Scopus subject areas

  • Epidemiology
  • Oncology

Cite this

Yokoyama, T., Yokoyama, A., Kumagai, Y., Omori, T., Kato, H., Igaki, H., ... Watanabe, H. (2008). Health risk appraisal models for mass screening of esophageal cancer in Japanese men. Cancer Epidemiology Biomarkers and Prevention, 17(10), 2846-2854. https://doi.org/10.1158/1055-9965.EPI-08-0397

Health risk appraisal models for mass screening of esophageal cancer in Japanese men. / Yokoyama, Tetsuji; Yokoyama, Akira; Kumagai, Yoshiya; Omori, Tai; Kato, Hoichi; Igaki, Hiroyasu; Tsujinaka, Toshimasa; Muto, Manabu; Yokoyama, Masako; Watanabe, Hiroshi.

In: Cancer Epidemiology Biomarkers and Prevention, Vol. 17, No. 10, 10.2008, p. 2846-2854.

Research output: Contribution to journalArticle

Yokoyama, T, Yokoyama, A, Kumagai, Y, Omori, T, Kato, H, Igaki, H, Tsujinaka, T, Muto, M, Yokoyama, M & Watanabe, H 2008, 'Health risk appraisal models for mass screening of esophageal cancer in Japanese men', Cancer Epidemiology Biomarkers and Prevention, vol. 17, no. 10, pp. 2846-2854. https://doi.org/10.1158/1055-9965.EPI-08-0397
Yokoyama, Tetsuji ; Yokoyama, Akira ; Kumagai, Yoshiya ; Omori, Tai ; Kato, Hoichi ; Igaki, Hiroyasu ; Tsujinaka, Toshimasa ; Muto, Manabu ; Yokoyama, Masako ; Watanabe, Hiroshi. / Health risk appraisal models for mass screening of esophageal cancer in Japanese men. In: Cancer Epidemiology Biomarkers and Prevention. 2008 ; Vol. 17, No. 10. pp. 2846-2854.
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AU - Kato, Hoichi

AU - Igaki, Hiroyasu

AU - Tsujinaka, Toshimasa

AU - Muto, Manabu

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AU - Watanabe, Hiroshi

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N2 - Background: Because early squamous cell carcinoma (SCC) of the esophagus is detectable by endoscopic esophageal iodine staining with high accuracy and is easily treated by endoscopic mucosectomy, it is important to develop efficient methods for screening candidates for the endoscopic examination. Inactive aldehyde dehydrogenase-2 (ALDH2) is a very strong risk factor for esophageal SCC in alcohol drinkers and thus may be suitable as a screening tool. Purpose: To assess the performance of health risk appraisal (HRA) models in screening for esophageal SCC in the Japanese male population. Methods: Two types of HRA models were developed based on our previous case-control study, which included assessment of ALDH2 activity and selected risk factors (HRA-G and HRA-F: activities of ALDH2 assessed by genotype and questionnaire for alcohol flushing, respectively). Each individual's risk of esophageal SCC was calculated quantitatively as a risk score. The sensitivity and specificity of the HRA models at various cutoff values of risk score was estimated by a leave-one-out cross-validation. The positive predictive value was estimated assuming the prevalence of esophageal SCC in the whole population to be 0.17% or 0.39% according to literatures. Results: When individuals ranked in the top 10% of the HRA-F risk score was screened, the sensitivity was 57.9% and positive predictive value was 0.93% or 2.12% according to the above assumptions, respectively. The sensitivity was slightly better by the HRA-G model than by the HRA-F model. Conclusion: The HRA models may provide an important approach to early intervention strategies to control esophageal SCC in Japanese men.

AB - Background: Because early squamous cell carcinoma (SCC) of the esophagus is detectable by endoscopic esophageal iodine staining with high accuracy and is easily treated by endoscopic mucosectomy, it is important to develop efficient methods for screening candidates for the endoscopic examination. Inactive aldehyde dehydrogenase-2 (ALDH2) is a very strong risk factor for esophageal SCC in alcohol drinkers and thus may be suitable as a screening tool. Purpose: To assess the performance of health risk appraisal (HRA) models in screening for esophageal SCC in the Japanese male population. Methods: Two types of HRA models were developed based on our previous case-control study, which included assessment of ALDH2 activity and selected risk factors (HRA-G and HRA-F: activities of ALDH2 assessed by genotype and questionnaire for alcohol flushing, respectively). Each individual's risk of esophageal SCC was calculated quantitatively as a risk score. The sensitivity and specificity of the HRA models at various cutoff values of risk score was estimated by a leave-one-out cross-validation. The positive predictive value was estimated assuming the prevalence of esophageal SCC in the whole population to be 0.17% or 0.39% according to literatures. Results: When individuals ranked in the top 10% of the HRA-F risk score was screened, the sensitivity was 57.9% and positive predictive value was 0.93% or 2.12% according to the above assumptions, respectively. The sensitivity was slightly better by the HRA-G model than by the HRA-F model. Conclusion: The HRA models may provide an important approach to early intervention strategies to control esophageal SCC in Japanese men.

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