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

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dc.contributor.authorTisler, Anna
dc.contributor.authorVõrk, Andres
dc.contributor.authorTammemägi, Martin
dc.contributor.authorOjavee, Sven Erik
dc.contributor.authorRaag, Mait
dc.contributor.authorŠavrova, Aleksandra
dc.contributor.authorNygård, Mari
dc.contributor.authorNygård, Jan F
dc.contributor.authorStankunas, Mindaugas
dc.contributor.authorKivite-Urtane, Anda
dc.contributor.authorUusküla, Anneli
dc.contributor.institutionInstitute of Public Health
dc.date.accessioned2024-10-23T15:20:03Z
dc.date.available2024-10-23T15:20:03Z
dc.date.issued2024-10-19
dc.descriptionPublisher Copyright: © 2024. The Author(s).
dc.description.abstractTransitioning 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.en
dc.description.statusPeer reviewed
dc.format.extent2006177
dc.identifier.citationTisler, A, Võrk, A, Tammemägi, M, Ojavee, S E, Raag, M, Šavrova, A, Nygård, M, Nygård, J F, Stankunas, M, Kivite-Urtane, A & Uusküla, A 2024, 'Nationwide study on development and validation of a risk prediction model for CIN3+ and cervical cancer in Estonia', Scientific Reports, vol. 14, no. 1, 24589. https://doi.org/10.1038/s41598-024-75697-3
dc.identifier.doi10.1038/s41598-024-75697-3
dc.identifier.issn2045-2322
dc.identifier.otherPubMedCentral: PMC11490536
dc.identifier.urihttps://dspace.rsu.lv/jspui/handle/123456789/16803
dc.identifier.urlhttps://www-webofscience-com.db.rsu.lv/wos/alldb/full-record/MEDLINE:39426992
dc.identifier.urlhttp://www.scopus.com/inward/record.url?scp=85206872258&partnerID=8YFLogxK
dc.language.isoeng
dc.relation.ispartofScientific Reports
dc.rightsinfo:eu-repo/semantics/openAccess
dc.subjectHumans
dc.subjectUterine Cervical Neoplasms/epidemiology
dc.subjectFemale
dc.subjectEstonia/epidemiology
dc.subjectUterine Cervical Dysplasia/epidemiology
dc.subjectMiddle Aged
dc.subjectAdult
dc.subjectRetrospective Studies
dc.subjectEarly Detection of Cancer/methods
dc.subjectRisk Assessment/methods
dc.subjectProportional Hazards Models
dc.subjectAged
dc.subject3.3 Health sciences
dc.subject1.1. Scientific article indexed in Web of Science and/or Scopus database
dc.subjectSDG 3 - Good Health and Well-being
dc.titleNationwide study on development and validation of a risk prediction model for CIN3+ and cervical cancer in Estoniaen
dc.type/dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article

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