Nationwide study on development and validation of a risk prediction model for CIN3+ and cervical cancer in Estonia

Anna Tisler (Corresponding Author), Andres Võrk, Martin Tammemägi, Sven Erik Ojavee, Mait Raag, Aleksandra Šavrova, Mari Nygård, Jan F Nygård, Mindaugas Stankunas, Anda Kivite-Urtane, Anneli Uusküla

Research output: Contribution to journalArticlepeer-review

1 Downloads (Pure)

Abstract

Transitioning to an individualized risk-based approach can significantly enhance cervical cancer screening programs. We aimed to derive and internally validate a prediction model for assessing the risk of cervical intraepithelial neoplasia grade 3 or higher (CIN3+) and cancer in women eligible for screening. This retrospective study utilized data from the Estonian electronic health records, including 517,884 women from the health insurance database and linked health registries. We employed Cox proportional hazard regression, incorporating reproductive and medical history variables (14 covariates), and utilized the least absolute shrinkage and selection operator (LASSO) for variable selection. A 10-fold cross-validation for internal validation of the model was used. The main outcomes were the performance of discrimination and calibration. Over the 8-year follow-up, we identified 1326 women with cervical cancer and 5929 with CIN3+, with absolute risks of 0.3% and 1.1%, respectively. The prediction model for CIN3 + and cervical cancer had good discriminative power and was well calibrated Harrell's C of 0.74 (0.73-0.74) (calibration slope 1.00 (0.97-1.02) and 0.67 (0.66-0.69) (calibration slope 0.92 (0.84-1.00) respectively. A developed model based on nationwide electronic health data showed potential utility for risk stratification to supplement screening efforts. This work was supported through grants number PRG2218 from the Estonian Research Council, and EMP416 from the EEA (European Economic Area) and Norway Grants.

Original languageEnglish
Article number24589
JournalScientific Reports
Volume14
Issue number1
DOIs
Publication statusPublished - 19 Oct 2024

Keywords*

  • Humans
  • Uterine Cervical Neoplasms/epidemiology
  • Female
  • Estonia/epidemiology
  • Uterine Cervical Dysplasia/epidemiology
  • Middle Aged
  • Adult
  • Retrospective Studies
  • Early Detection of Cancer/methods
  • Risk Assessment/methods
  • Proportional Hazards Models
  • Aged

Field of Science*

  • 3.3 Health sciences

Publication Type*

  • 1.1. Scientific article indexed in Web of Science and/or Scopus database

Fingerprint

Dive into the research topics of 'Nationwide study on development and validation of a risk prediction model for CIN3+ and cervical cancer in Estonia'. Together they form a unique fingerprint.

Cite this