Developing genetic epidemiological models to predict risk for nasopharyngeal carcinoma in high-risk population of China

PLoS One. 2013;8(2):e56128. doi: 10.1371/journal.pone.0056128. Epub 2013 Feb 15.

Abstract

To date, the only established model for assessing risk for nasopharyngeal carcinoma (NPC) relies on the sero-status of the Epstein-Barr virus (EBV). By contrast, the risk assessment models proposed here include environmental risk factors, family history of NPC, and information on genetic variants. The models were developed using epidemiological and genetic data from a large case-control study, which included 1,387 subjects with NPC and 1,459 controls of Cantonese origin. The predictive accuracy of the models were then assessed by calculating the area under the receiver-operating characteristic curves (AUC). To compare the discriminatory improvement of models with and without genetic information, we estimated the net reclassification improvement (NRI) and integrated discrimination index (IDI). Well-established environmental risk factors for NPC include consumption of salted fish and preserved vegetables and cigarette smoking (in pack years). The environmental model alone shows modest discriminatory ability (AUC = 0.68; 95% CI: 0.66, 0.70), which is only slightly increased by the addition of data on family history of NPC (AUC = 0.70; 95% CI: 0.68, 0.72). With the addition of data on genetic variants, however, our model's discriminatory ability rises to 0.74 (95% CI: 0.72, 0.76). The improvements in NRI and IDI also suggest the potential usefulness of considering genetic variants when screening for NPC in endemic areas. If these findings are confirmed in larger cohort and population-based case-control studies, use of the new models to analyse data from NPC-endemic areas could well lead to earlier detection of NPC.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Carcinoma
  • Case-Control Studies
  • China / epidemiology
  • Computer Simulation
  • Female
  • Humans
  • Male
  • Models, Biological
  • Models, Genetic
  • Nasopharyngeal Carcinoma
  • Nasopharyngeal Neoplasms / epidemiology*
  • Nasopharyngeal Neoplasms / genetics*
  • Nasopharyngeal Neoplasms / pathology
  • Nasopharynx / metabolism
  • Nasopharynx / pathology
  • Polymorphism, Single Nucleotide
  • Risk Factors

Grants and funding

This work was funded by the National Natural Science Foundation of China Projects of International Cooperation and Exchanges (81220108022), the National High Technology Research and Development Program of China (2012AA02A206 and 2012AA02A501), the State Basic Research Development Program of China (2011CB504303), the Ministry of Science and Technology of China (2011ZX11307), and the National Science and Technology Major Project (2008ZX09312-002). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.