RESEARCHERS have developed and validated an oesophageal and gastric cancer risk score using UK Biobank data, designed to identify adults aged over 50 at elevated risk of upper gastrointestinal cancer using only self-reported clinical and lifestyle information.
Gastric Cancer Risk Score
Researchers drew on 375,280 participants aged 50 years and older within the UK Biobank cohort to derive a screening tool for gastric and oesophageal cancer risk.
Candidate predictors included sociodemographic factors, lifestyle behaviours, medication use and medical history, with selection restricted to variables reliably self-reported in routine care contexts. Using COX regression models with LASSO penalisation, the final model retained eight predictors: sex, age, smoking status, alcohol consumption, body mass index, history of oesophagitis, use of gastric acid inhibitors, and prior surgery involving the stomach or oesophagus.
Strengths and Limitations
Authors noted several strengths and limitations of this study. The risk score is based on a large, well-characterised UK Biobank cohort with a median follow-up of 11.7 years, exceeding that of many comparable studies. It uses simple, self-reported variables that are widely available in the general population and straightforward to obtain, supporting ease of implementation.
However, limitations remain. Relevant predictors may have been missed due to data constraints within UK Biobank. Although LASSO regression guided variable selection, alternative methods may have identified different predictors. Additional interactions between variables may also exist but were not fully explored. The model was developed in a single-country UK population, which may limit transferability to other settings without further evaluation.
Conclusion
To conclude, a self-reported risk score for oesophageal and gastric cancer has been developed for individuals aged over 50 years in a low-to-middle incidence setting. Based on eight simple variables, it showed moderate discriminatory performance and identified a small high-risk subgroup defined by a 10-year risk threshold of at least 1%. The authors note that further work within the RISC-GAP project will assess whether adding clinical and biomarker data can improve prediction. Any future implementation will depend on evidence of mortality benefit and cost-effectiveness of a risk-adapted screening approach.
Reference
Schmitz T et al. Risk score for esophageal and gastric cancer in the over 50-year-old population based on self-reported information -the RISC-GAP project. BMC Gastroenterol. 2026;26(1):387.
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