Predicting Lung Cancer Occurrence in Never-Smoking Females in Asia: TNSF-SQ, a Prediction Model

Li Hsin Chien, Chung Hsing Chen, Tzu Yu Chen, Gee Chen Chang, Ying Huang Tsai, Chin Fu Hsiao, Kuan Yu Chen, Wu Chou Su, Wen Chang Wang, Ming Shyan Huang, Yuh Min Chen, Chih Yi Chen, Sheng Kai Liang, Chung Yu Chen, Chih Liang Wang, Mei Hsuan Lee, Ren Hua Chung, Fang Yu Tsai, Jia Wei Hu, Hormuzd A. KatkiNilanjan Chatterjee, Stephen J. Chanock, Nathaniel Rothman, Qing Lan, Pan Chyr Yang, Chien Jen Chen, I. Shou Chang, Chao A. Hsiung

Research output: Contribution to journalArticlepeer-review

25 Citations (Scopus)


Background: High disease burden suggests the desirability to identify high-risk Asian never-smoking females (NSF) who may benefit from low-dose CT (LDCT) screening. In North America, one is eligible for LDCT screening if one satisfies the U.S. Preventive Services Task Force (USPSTF) criteria or has model-estimated 6-year risk greater than 0.0151. According to two U.S. reports, only 36.6% female patients with lung cancer met the USPSTF criteria, while 38% of the ever-smokers ages 55 to 74 years met the USPSTF criteria. Methods: Using data on NSFs in the Taiwan Genetic Epidemiology Study of Lung Adenocarcinoma and the Taiwan Biobank before August 2016, we formed an age-matched case-control study consisting of 1,748 patients with lung cancer and 6,535 controls. Using these and an estimated age-specific lung cancer 6-year incidence rate among Taiwanese NSFs, we developed the Taiwanese NSF Lung Cancer Risk Models using genetic information and simplified questionnaire (TNSF-SQ). Performance evaluation was based on the newer independent datasets: Taiwan Lung Cancer Pharmacogenomics Study (LCPG) and Taiwan Biobank data after August 2016 (TWB2). Results: TheAUCbased on the NSFs ages 55 to 70 years in LCPG and TWB2 was 0.714 [95% confidence intervals (CI), 0.660-0.768]. For women in TWB2 ages 55 to 70 years, 3.94% (95% CI, 2.95-5.13) had risk higher than 0.0151. For women in LCPG ages 55 to 74 years, 27.03% (95% CI, 19.04-36.28) had risk higher than 0.0151. Conclusions: TNSF-SQ demonstrated good discriminative power. The ability to identify 27.03% of high-risk Asian NSFs ages 55 to 74 years deserves attention. Impact: TNSF-SQ seems potentially useful in selecting Asian NSFs for LDCT screening.

ASJC Scopus subject areas

  • Epidemiology
  • Oncology


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