ArticleJournal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer2024
Lung Cancer Risk Prediction Models for Asian Ever-Smokers.
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Article in Journal of thoracic oncology : official publication of the International Association for the Study of Lung Cancer, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 3 of them syntheses that pooled it.
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18 citing papers in PubMed, 3 syntheses or guidelines pooled it, 18 citations in OpenAlex.
- Risk prediction for lung cancer screening: a systematic review and meta-regression.European respiratory review : an official journal of the European Respiratory Society · 2026Pooled it
- Cost-effectiveness of lung cancer screening: insights from risk stratification, guidelines, and emerging technologies-a systematic review.NPJ primary care respiratory medicine · 2026Pooled it
- Predictive performance of risk prediction models for lung cancer incidence in Western and Asian countries: a systematic review and meta-analysis.Scientific reports · 2025Pooled it
- Pulmonary nodules: classification, biomarkers, signaling pathways, diseases, early diagnosis and management.Signal transduction and targeted therapy · 2026Review
- Screening Eligibility and Survival Among Patients With Lung Cancer in Korea.JAMA network open · 2026Article
- Lung cancer risk prediction models and asbestos exposure: a validation study on the Western Australia Asbestos Review Program.Occupational and environmental medicine · 2026Article
- Research on Risk Transfer Pathways for Lung Cancer Among Middle-Aged and Older Individuals Using Deep Reinforcement Learning: Retrospective Cohort Study.JMIR medical informatics · 2026Article
- From evidence to action: the IARC's role in strengthening cancer prevention and early detection.Journal of the National Cancer Institute. Monographs · 2026Review
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- Lung cancer in never-smoking females: epidemiology, risk factors and screening.Frontiers in public health · 2026Review
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- Current lung cancer screening: a call for comprehensive reassessment.Journal of thoracic disease · 2025Article
- Updates in Lung Cancer Screening: A Decade of Evidence.Seminars in respiratory and critical care medicine · 2025Review
- Cost-effectiveness of risk model-based lung cancer screening in smokers and nonsmokers in China.BMC medicine · 2025Article
- Assessment and recalibration of seventeen lung cancer risk prediction models in approximately one million Chinese population utilising healthcare big data: a retrospective cohort analysis.The Lancet regional health. Western Pacific · 2025Article
- Head-to-head comparisons of risk discrimination by questionnaire-based lung cancer risk prediction models: a systematic review and meta-analysis.EClinicalMedicine · 2025Article
- Analysis of risk factors for early detection of cystic lung cancer based on CT genomics and its relationship with pathological invasion.Polish journal of radiology · 2025Article
- Exploratory evidence maps for the WHO Classification of Tumours 5th edition for lung and thymus tumors.Virchows Archiv : an international journal of pathology · 2024Article
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Authors and funding
51 authors at 20 institutions in 11 countries.
Jae Jeong YangDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee; Department of Surgery, University of Florida College of Medicine, Gainesville, Florida; University of Florida Health Cancer Center, Gainesville, Florida.
Wanqing WenDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Hana ZahedInternational Agency for Research on Cancer, Lyon, France.
Wei ZhengDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Qing LanDivision of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
Sarah K AbeDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Md Shafiur RahmanDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan; Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.
Md Rashedul IslamDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan; Hitotsubashi Institute for Advanced Study, Hitotsubashi University, Tokyo, Japan.
Eiko SaitoInstitute for Global Health Policy Research, National Center for Global Health and Medicine, Tokyo, Japan.
Prakash C GuptaHealis - Sekhsaria Institute for Public Health Mahaleb, Navi Mumbai, India.
Akiko TamakoshiDepartment of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
Woon-Puay KohHealthy Longevity Translational Research Program, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore; Singapore Institute for Clinical Sciences, Agency for Science Technology and Research (A∗STAR), Singapore, Singapore.
Yu-Tang GaoDepartment of Epidemiology, Shanghai Cancer Institute Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Ritsu SakataRadiation Effects Research Foundation, Hiroshima, Japan.
Ichiro TsujiTohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
Reza MalekzadehDigestive Oncology Research Center, Digestive Diseases Research Institute, Tehran University of Medical Sciences, Tehran, Iran.
Yumi SugawaraTohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
Jeongseon KimGraduate School of Cancer Science and Policy, National Cancer Center, Goyang, Republic of Korea.
Hidemi ItoDivision of Cancer Information and Control, Department of Preventive Medicine, Aichi Cancer Center Research Institute, Nagoya, Japan; Division of Descriptive Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Chisato NagataDepartment of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
San-Lin YouSchool of Medicine & Big Data Research Center, Fu Jen Catholic University, New Taipei City, Taiwan.
Sue K ParkDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Jian-Min YuanDivision of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.
Myung-Hee ShinDepartment of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Sun-Seog KweonDepartment of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Sang-Wook YiDepartment of Preventive Medicine and Public Health, Catholic Kwandong University College of Medicine, Gangneung, Republic of Korea.
Mangesh S PednekarHealis - Sekhsaria Institute for Public Health Mahaleb, Navi Mumbai, India.
Takashi KimuraDepartment of Public Health, Hokkaido University Faculty of Medicine, Sapporo, Japan.
Hui CaiDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee.
Yukai LuTohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
Arash EtemadiMetabolic Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, Maryland.
Seiki KanemuraTohoku University Graduate School of Medicine, Miyagi Prefecture, Japan.
Keiko WadaDepartment of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.
Chien-Jen ChenGenomics Research Center, Academia Sinica, Taipei City, Taiwan.
Aesun ShinDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
Renwei WangDivision of Cancer Control and Population Sciences, UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania.
Yoon-Ok AhnDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Min-Ho ShinDepartment of Preventive Medicine, Chonnam National University Medical School, Gwangju, Republic of Korea.
Heechoul OhrrDepartment of Preventive Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Mahdi SheikhInternational Agency for Research on Cancer, Lyon, France.
Batel BlechterDivision of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
Habibul AhsanDepartment of Public Health Sciences, University of Chicago, Illinois.
Paolo BoffettaStony Brook Cancer Center, Stony Brook University, Stony Brook, New York; Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
Kee Seng ChiaSaw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore.
Keitaro MatsuoDivision Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan; Department of Cancer Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
You-Lin QiaoSchool of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Nathaniel RothmanDivision of Cancer Epidemiology and Genetics, Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Rockville, Maryland.
Manami InoueDivision of Prevention, National Cancer Center Institute for Cancer Control, Tokyo, Japan.
Daehee KangDepartment of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea; Cancer Research Institute, Seoul National University, Seoul, Republic of Korea.
Hilary A RobbinsInternational Agency for Research on Cancer, Lyon, France.
Xiao-Ou ShuDivision of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: xiao-ou.shu@vanderbilt.edu.
National Institutes of Health · USSeoul National University · KRTohoku University · JPVanderbilt University Medical Center · USCentre international de recherche sur le cancer · FRChonnam National University · KRAichi Cancer Center · JPGifu University · JPHealis Sekhsaria Institute For Public Health · INHokkaido University · JPAgency for Science, Technology and Research · SGCatholic Kwandong University · KRChicago Department of Public Health · USChinese Academy of Medical Sciences & Peking Union Medical College · CNFu Jen Catholic University · TWGenomics Research Center, Academia Sinica · TWHamamatsu University School of Medicine · JPHitotsubashi University · JPNational Cancer Center · KRNational Center for Global Health and Medicine · JP
Funding
Translating Molecular and Clinical Data to Population Lung Cancer Risk AssessmentU19CA203654 · NCI · UNIVERSITY OF NEW MEXICO HEALTH SCIS CTR · PI Christopher I. Amos · 2017 to 2026
$23.7MPilot Program CoreP30ES027792 · NIEHS · UNIVERSITY OF CHICAGO · PI Gokhan M. Mutlu, Gail S Prins · 2017 to 2026
$13.6MProspective studies of cancer etiology and prevention in Shanghai and SingaporeR01CA144034 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI YUAN, JIAN-MIN · 2010 to 2014
$7.0MCohort Study of Cancer inhibitory Factors in MenR01CA082729 · NCI · VANDERBILT UNIVERSITY · PI SHU, XIAO-OU · 2001 to 2011
$6.3MShanghai Womens Health StudyUM1CA182910 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ZHENG, WEI · 2014 to 2018
$5.9MDIETARY FACTORS IN THE ETIOLOGY OF CANCER IN SHANGHAIR01CA043092 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI YUAN, JIAN-MIN · 1987 to 2006
$5.8MTHE SINGAPORE COHORT STUDY OF DIET AND CANCERR01CA080205 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI YUAN, JIAN-MIN · 1999 to 2009
$5.3MShanghai Men's Health StudyUM1CA173640 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI SHU, XIAO-OU · 2013 to 2017
$4.9MCancer Risk Reduction and Diet: A Cohort Study of WomenR37CA070867 · NCI · VANDERBILT UNIVERSITY MEDICAL CENTER · PI ZHENG, WEI · 2009 to 2013
$4.7MCancer epidemiology cohorts in Shanghai and Singapore UM1CA182876 · NCI · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI YUAN, JIAN-MIN · 2014 to 2018
$4.3MEvaluating risk prediction models for use in lung cancer screening in diverse populations around the worldR03CA245979 · NCI · INTERNATIONAL AGENCY FOR RES ON CANCER · PI ROBBINS, HILARY A. · 2020 to 2020
$112kENVIRONMENTAL EXPOSURES IN CANCER ETIOLOGYR35CA053890 · NCI · UNIVERSITY OF SOUTHERN CALIFORNIA · PI YU, MIMI C. · 1992 to 1998
–NCI NIH HHS R01 CA043092NCI NIH HHS R01 CA055069NCI NIH HHS R01 CA080205NCI NIH HHS R01 CA082729NCI NIH HHS R01 CA144034NCI NIH HHS R03 CA245979NCI NIH HHS R35 CA053890NCI NIH HHS R37 CA070867NCI NIH HHS U19 CA203654NCI NIH HHS UM1 CA173640NCI NIH HHS UM1 CA182876NCI NIH HHS UM1 CA182910NIEHS NIH HHS P30 ES027792World Health Organization 001
Abstract
introductionAlthough lung cancer prediction models are widely used to support risk-based screening, their performance outside Western populations remains uncertain. This study aims to evaluate the performance of 11 existing risk prediction models in multiple Asian populations and to refit prediction models for Asians.
methodsIn a pooled analysis of 186,458 Asian ever-smokers from 19 prospective cohorts, we assessed calibration (expected-to-observed ratio) and discrimination (area under the receiver operating characteristic curve [AUC]) for each model. In addition, we developed the "Shanghai models" to better refine risk models for Asians on the basis of two well-characterized population-based prospective cohorts and externally validated them in other Asian cohorts.
resultsAmong the 11 models, the Lung Cancer Death Risk Assessment Tool yielded the highest AUC (AUC [95% confidence interval (CI)] = 0.71 [0.67-0.74] for lung cancer death and 0.69 [0.67-0.72] for lung cancer incidence) and the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial Model had good calibration overall (expected-to-observed ratio [95% CI] = 1.06 [0.90-1.25]). Nevertheless, these models substantially underestimated lung cancer risk among Asians who reported less than 10 smoking pack-years or stopped smoking more than or equal to 20 years ago. The Shanghai models were found to have marginal improvement overall in discrimination (AUC [95% CI] = 0.72 [0.69-0.74] for lung cancer death and 0.70 [0.67-0.72] for lung cancer incidence) but consistently outperformed the selected Western models among low-intensity smokers and long-term quitters.
conclusionsThe Shanghai models had comparable performance overall to the best existing models, but they improved much in predicting the lung cancer risk of low-intensity smokers and long-term quitters in Asia.
Indexed as
Lung NeoplasmsChinaEarly Detection of CancerHumansLungMaleProspective StudiesRisk AssessmentRisk FactorsSmokersAsiaCalibrationCohortDiscriminationLung cancerRisk prediction model
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