Prediction Models for Gastric Cancer Risk in the General Population: A Systematic Review

Abstract

Risk prediction models for gastric cancer could identify high-risk individuals in the general population. The objective of this study was to systematically review the available evidence about the construction and verification of gastric cancer predictive models. We searched PubMed, Embase, and Cochrane Library databases for articles that developed or validated gastric cancer risk prediction models up to November 2021. Data extracted included study characteristics, predictor selection, missing data, and evaluation metrics. Risk of bias (ROB) was assessed using the Prediction model Risk Of Bias Assessment Tool (PROBAST). We identified a total of 12 original risk prediction models that fulfilled the criteria for analysis. The area under the receiver operating characteristic curve (AUC) ranged from 0.73 to 0.93 in derivation sets (n = 6), 0.68 to 0.90 in internal validation sets (n = 5), 0.71 to 0.92 in external validation sets (n = 7). The higher-performing models usually include age, salt preference, Helicobacter pylori, smoking, body mass index, family history, pepsinogen, and sex. According to PROBAST, at least one domain with a high ROB was present in all studies mainly due to methodologic limitations in the analysis domain. In conclusion, although some risk prediction models including similar predictors have displayed sufficient discriminative abilities, many have a high ROB due to methodologic limitations and are not externally validated efficiently. Future prediction models should adherence to well-established standards and guidelines to benefit gastric cancer screening.

Prevention relevance: Through systematical reviewing available evidence about the construction and verification of gastric cancer predictive models, we found that most models have a high ROB due to methodologic limitations and are not externally validated efficiently. Future prediction models are supposed to adherence to well-established standards and guidelines to benefit gastric cancer screening.