BACKGROUND: Head and neck cancer (HNC) incidence is on the rise, often diagnosed at late stage and associated with poor prognoses. Risk prediction tools have a potential role in prevention and early detection. METHODS: The IARC-ARCAGE European case-control study was used as the model development dataset. A clinical HNC risk prediction model using behavioral and demographic predictors was developed via multivariable logistic regression analyses. The model was then externally validated in the UK Biobank cohort. Model performance was tested using discrimination and calibration metrics. RESULTS: 1926 HNC cases and 2043 controls were used for the development of the model. The development dataset model including sociodemographic, smoking, and alcohol variables had moderate discrimination, with an area under curve (AUC) value of 0.75 (95% CI, 0.74-0.77); the calibration slope (0.75) and tests were suggestive of good calibration. 384 616 UK Biobank participants (with 1177 HNC cases) were available for external validation of the model. Upon external validation, the model had an AUC of 0.62 (95% CI, 0.61-0.64). CONCLUSION: We developed and externally validated a HNC risk prediction model using the ARCAGE and UK Biobank studies, respectively. This model had moderate performance in the development population and acceptable performance in the validation dataset. Demographics and risk behaviors are strong predictors of HNC, and this model may be a helpful tool in primary dental care settings to promote prevention and determine recall intervals for dental examination. Future addition of HPV serology or genetic factors could further enhance individual risk prediction.

Bristol Dental School University of Bristol Bristol United Kingdom

Cancer Epidemiology Unit Department of Medical Sciences University of Turin and CPO Piemonte Turin Italy

Cancer Research UK Scotland Institute Glasgow United Kingdom

Cancer Surveillance Branch International Agency for Research on Cancer Lyon France

Catalan Institute of Oncology IDIBELL Barcelona Spain

Centre for Oral Health Research Newcastle University Newcastle upon Tyne United Kingdom

Deutsches Krebsforschungszentrum Heidelberg Germany

Epidemiology Group School of Medicine Medical Sciences and Nutrition University of Aberdeen Aberdeen United Kingdom

Genomic Epidemiology Group International Agency for Research on Cancer Lyon France

Glasgow Head and Neck Cancer Research Group Glasgow United Kingdom

Institute of Hygiene and Epidemiology 1st Faculty of Medicine Charles University Prague Czech Republic

Leibniz Institute for Prevention Research and Epidemiology BIPS Bremen Germany

School of Cancer Sciences University of Glasgow Glasgow United Kingdom

School of Dental Science Trinity College Dublin Dublin Ireland

School of Health and Wellbeing University of Glasgow Glasgow United Kingdom

School of Health Science and Wellbeing Staffordshire University Staffordshire United Kingdom

School of Medicine Dentistry and Nursing University of Glasgow Glasgow United Kingdom

School of Medicine National and Kapodistrian University of Athens Athens Greece

Unit of Biostatistics Epidemiology and Public Health Department of Cardio Thoraco Vascular Sciences and Public Health University of Padua Padova Italy

Unit of Cancer Epidemiology Centro di Riferimento Oncologico di Aviano IRCCS Aviano Italy

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