Identifying patients with undetected colorectal cancer: an independent validation of QCancer (Colorectal)

被引:40
作者
Collins, G. S. [1 ]
Altman, D. G. [1 ]
机构
[1] Univ Oxford, Wolfson Coll Annexe, Ctr Stat Med, Oxford OX2 6UD, England
关键词
colorectal cancer; diagnosis; risk prediction; QCancer; validation; PRIMARY-CARE; EARLY-DIAGNOSIS; OVARIAN-CANCER; SURVIVAL; SYMPTOMS; MODELS; RISK; FEATURES; IMPACT;
D O I
10.1038/bjc.2012.266
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BACKGROUND: Early identification of colorectal cancer is an unresolved challenge and the predictive value of single symptoms is limited. We evaluated the performance of QCancer (Colorectal) prediction model for predicting the absolute risk of colorectal cancer in an independent UK cohort of patients from general practice records. METHODS: A total of 2.1 million patients registered with a general practice surgery between 01 January 2000 and 30 June 2008, aged 30-84 years (3.7 million person-years) with 3712 colorectal cancer cases were included in the analysis. Colorectal cancer was defined as incident diagnosis of colorectal cancer during the 2 years after study entry. RESULTS: The results from this independent and external validation of QCancer (Colorectal) prediction model demonstrated good performance data on a large cohort of general practice patients. QCancer (Colorectal) had very good discrimination with an area under the ROC curve of 0.92 (women) and 0.91 (men), and explained 68% (women) and 66% (men) of the variation. QCancer (Colorectal) was well calibrated across all tenths of risk and over all age ranges with predicted risks closely matching observed risks. CONCLUSION: QCancer (Colorectal) appears to be a useful tool for identifying undetected cases of undiagnosed colorectal cancer in primary care in the United Kingdom. British Journal of Cancer (2012) 107, 260-265. doi:10.1038/bjc.2012.266 www.bjcancer.com Published online 14 June 2012 (c) 2012 Cancer Research UK
引用
收藏
页码:260 / 265
页数:6
相关论文
共 31 条
[1]   What if cancer survival in Britain were the same as in Europe: how many deaths are avoidable? [J].
Abdel-Rahman, M. ;
Stockton, D. ;
Rachet, B. ;
Hakulinen, T. ;
Coleman, M. P. .
BRITISH JOURNAL OF CANCER, 2009, 101 :S115-S124
[2]   Most bowel cancer symptoms do not indicate colorectal cancer and polyps: a systematic review [J].
Adelstein, Barbara-Ann ;
Macaskill, Petra ;
Chan, Siew F. ;
Katelaris, Peter H. ;
Irwig, Les .
BMC GASTROENTEROLOGY, 2011, 11
[3]  
[Anonymous], 2011, R: A Language and Environment for Statistical Computing
[4]  
[Anonymous], 2005, REF GUID SUSP CANC
[5]   Diagnostic value of symptoms for colorectal cancer in primary care: a systematic review [J].
Hamilton, William ;
Astin, Margaret ;
Griffin, Tom ;
Neal, Richard D. ;
Rose, Peter .
BRITISH JOURNAL OF GENERAL PRACTICE, 2011, 61 (586) :e231-e243
[6]   Diagnostic accuracy systematic review of rectal bleeding in combination with other symptoms, signs and tests in relation to colorectal cancer [J].
Bekkink, M. Olde ;
McCowan, C. ;
Falk, G. A. ;
Teljeur, C. ;
Van de Laar, F. A. ;
Fahey, T. .
BRITISH JOURNAL OF CANCER, 2010, 102 (01) :48-58
[7]   Survival for eight major cancers and all cancers combined for European adults diagnosed in 1995-99: results of the EUROCARE-4 study [J].
Berrino, Franco ;
De Angelis, Roberta ;
Sant, Milena ;
Rosso, Stefano ;
Lasota, Magdalena B. ;
Coebergh, Jan W. ;
Santaquilani, Mariano .
LANCET ONCOLOGY, 2007, 8 (09) :773-783
[8]   Missing covariate data within cancer prognostic studies: a review of current reporting and proposed guidelines [J].
Burton, A ;
Altman, DG .
BRITISH JOURNAL OF CANCER, 2004, 91 (01) :4-8
[9]   Developing a prognostic model in the presence of missing data: an ovarian cancer case study [J].
Clark, TG ;
Altman, DG .
JOURNAL OF CLINICAL EPIDEMIOLOGY, 2003, 56 (01) :28-37
[10]  
Ferlay J., 2010, IARC CancerBase, V10