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Heterogeneity of Cancer Risk Due to Stochastic Effects
Author(s) -
Heidenreich Wolfgang F.
Publication year - 2005
Publication title -
risk analysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.972
H-Index - 130
eISSN - 1539-6924
pISSN - 0272-4332
DOI - 10.1111/j.1539-6924.2005.00685.x
Subject(s) - percentile , population , cancer , risk assessment , demography , relative risk , incidence (geometry) , medicine , statistics , environmental health , mathematics , computer science , confidence interval , computer security , sociology , geometry
Persons with exactly the same genetic background, behavior, environment, etc. may have differences in cancer risk due to a different number of cells on the way to malignancy. These differences are estimated quantitatively by using the two‐stage clonal expansion model. For liver cancer the estimated relative risk for persons without intermediate cells at age 40 is less than 10% when compared to the risk of the total population, while the top 0.1% risk group has a more than 100‐fold risk compared to the population. The risk of the 1% percentile in risk is more than 100‐fold of the risk of the more than 95% persons without intermediate cells. The number of intermediate (premalignant) cells in the risk groups cannot be calculated from incidence data only because they depend strongly on a nonidentifiable parameter. But under plausible assumptions, less than about 1,000 intermediate cells are present at age 40 even in high‐risk persons.