This tool was designed for use by health providers with their patients. Please take these results to your health provider to discuss your personal risk of esophageal adenocarcinoma. IC-RISC™ (“Interactive & Contextual RISk Calculator”) currently applies only to white males, black males and white females, which are the groups with the most accurate information on incidence and risk factors. The incidence of EA is very low in black females, and little risk factor information is available specifically for Hispanics or persons of other ethnic/racial backgrounds.
Esophageal adenocarcinoma (EA) is an aggressive cancer usually arising in the lower part of the esophagus near the stomach. Once quite rare, its incidence has risen substantially over the past four decades in the U.S. and many other developed countries. It is most common among white males, although incidence rates in other groups also have risen. Unless diagnosed at an early stage, long term survival with EA remains poor. Therefore preventing the cancer and detecting it at an early stage remain the most effective options.
Epidemiologic and clinical research has revealed many risk factors which, taken together, can help estimate a person's probability of developing this cancer. These include demographic factors, host and lifestyle factors, medications, family history, and genetic markers. IC-RISC™ uses an individual's risk factor profile to estimate his/her absolute risk of developing EA over the next ten years. While incidence of this cancer has increased, it is still relatively rare. To put this in perspective, risk of developing EA is displayed in the context of risk of dying from other cancers or from causes such as injury, stroke or heart disease. In this way the tool can help inform discussions between a health provider and patient regarding:
Enter values for risk and preventive factors on the left side of page, Separate tabs are available to aid in calculating BMI and categorizing usual physical activity. The estimated 10-yr probability of developing EA is displayed on the right side in two ways:
This application should not be considered, or used as a substitute for, medical advice, diagnosis or treatment. This site does not constitute the practice of any medical, nursing or other professional health care advice, diagnosis or treatment.
Note: Disease incidence and mortality rates used in IC-RISC™ are specific for the U.S.; comparison mortality rates are specific for age, sex and race, but do not take into account other risk factors.
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IC-RISC software is made available for academic and other non-profit use under the 2-Clause BSD License:
Copyright 2018 Thomas L Vaughan
Redistribution and use in source and binary forms, with or without modification, are permitted provided that the following conditions are met:
Redistributions of source code must retain the above copyright notice, this list of conditions and the following disclaimer.
Redistributions in binary form must reproduce the above copyright notice, this list of conditions and the following disclaimer in the documentation and/or other materials provided with the distribution.
THIS SOFTWARE IS PROVIDED BY THE COPYRIGHT HOLDERS AND CONTRIBUTORS “AS IS” AND ANY EXPRESS OR IMPLIED WARRANTIES, INCLUDING, BUT NOT LIMITED TO, THE IMPLIED WARRANTIES OF MERCHANTABILITY AND FITNESS FOR A PARTICULAR PURPOSE ARE DISCLAIMED. IN NO EVENT SHALL THE COPYRIGHT HOLDER OR CONTRIBUTORS BE LIABLE FOR ANY DIRECT, INDIRECT, INCIDENTAL, SPECIAL, EXEMPLARY, OR CONSEQUENTIAL DAMAGES (INCLUDING, BUT NOT LIMITED TO, PROCUREMENT OF SUBSTITUTE GOODS OR SERVICES; LOSS OF USE, DATA, OR PROFITS; OR BUSINESS INTERRUPTION) HOWEVER CAUSED AND ON ANY THEORY OF LIABILITY, WHETHER IN CONTRACT, STRICT LIABILITY, OR TORT (INCLUDING NEGLIGENCE OR OTHERWISE) ARISING IN ANY WAY OUT OF THE USE OF THIS SOFTWARE, EVEN IF ADVISED OF THE POSSIBILITY OF SUCH DAMAGE.
IC-RISC software will be made available for commercial use under a negotiated license.
For academic and other non-profit use, download software at: https://github.com/FredHutch/IC-RISC-Working
For commercial use, contact Fred Hutchinson Cancer Center, Business Development & Strategy (206.667.4304)
There are many individuals who helped develop and shape IC-RISC™, and I am grateful to all. These include Lynn Onstad, James Dai and Li Hsu at Fred Hutch (http://fredhutch.org) who offered guidance and programming support for estimating risk and confidence intervals while accounting for competing mortality; Patty Galipeau, also at Fred Hutch, who suggested many usability improvements; and members of the BEACON consortium (http://beacon.tlvnet.net) and CISNET esophageal network (https://cisnet.cancer.gov/esophagus/) who offered helpful advice at multiple points during its development.
Please contact Dr. Thomas Vaughan with questions or suggestions at tvaughan (at) uw (dot) edu.
Additional information regarding how an esophageal cancer risk calculator and decision tool might be incorporated into clinical practice can be found in the figure (from ref #3) and following publications:
Thrift AP, Kendall BJ, Pandeya N, Whiteman DC. A Model to Determine Absolute Risk for Esophageal Adenocarcinoma. Clinical Gastroenterology and Hepatology 11, 138–144.e2 (2013).
Thrift AP and Whiteman DC. Can we really predict risk of cancer? Cancer Epidemiology 37, 349–52 (2013).
Vaughan TL. From genomics to diagnostics of esophageal adenocarcinoma. Nature Genetics. 46, 806-807 (2014). (See figure)
Rubenstein JH, et al. Prediction of Barrett’s esophagus among men. The American journal of gastroenterology 108, 353–62 (2013). http://mberet.umms.med.umich.edu/
Vaughan TL and Fitzgerald RC. Precision prevention of oesophageal adenocarcinoma. Nature Reviews Gastroenterol Hepatol 12, 243-48 (2015).
Xie S-H, Lagergren, J. A Model for Predicting Individual Absolute Risk of Esophageal Adenocarcinoma: Moving towards Tailored Screening and Prevention. Int. J. Cancer doi:10.1002/ijc.29988 (2016).
Ross-Innes CS, et al. Risk stratification of Barrett’s oesophagus using a non-endoscopic sampling method coupled with a biomarker panel: a cohort study. Lancet Gastroenterol Hepatol 2, 23–31 (2017).
The National Cancer Institute maintains a site devoted to cancer risk models: https://epi.grants.cancer.gov/cancer_risk_prediction/