Lung Cancer Risk Prediction Nomogram in Nonsmoking Chinese Women: Retrospective Cross-sectional Cohort Study

Abstract

Background It is believed that smoking is not the cause of approximately 53% of lung cancers diagnosed in women globally. Objective The study aimed to develop and validate a simple and noninvasive model that could assess and stratify lung cancer risk in nonsmoking Chinese women. Methods Based on the population-based Cancer Screening Program in Urban China, this retrospective, cross-sectional cohort study was carried out with a vast population base and an immense number of participants. The training set and the validation set were both constructed using a random distribution of the data. Following the identification of associated risk factors by multivariable Cox regression analysis, a predictive nomogram was developed. Discrimination (area under the curve) and calibration were further performed to assess the validation of risk prediction nomogram in the training set, which was then validated in the validation set. Results In sum, 151,834 individuals signed up to take part in the survey. Both the training set (n=75,917) and the validation set (n=75,917) were comprised of randomly selected participants. Potential predictors for lung cancer included age, history of chronic respiratory disease, first-degree family history of lung cancer, menopause, and history of benign breast disease. We displayed 1-year, 3-year, and 5-year lung cancer risk–predicting nomograms using these 5 factors. In the training set, the 1-year, 3-year, and 5-year lung cancer risk areas under the curve were 0.762, 0.718, and 0.703, respectively. In the validation set, the model showed a moderate predictive discrimination. Conclusions We designed and validated a simple and noninvasive lung cancer risk model for nonsmoking women. This model can be applied to identify and triage people at high risk for developing lung cancers among nonsmoking women.