| Title: | Personalised lung cancer risk stratification and lung cancer screening: do general practice electronic medical records have a role? |
| Journal: | British Journal of Cancer |
| Published: | 25 Oct 2023 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/37880510/ |
| DOI: | https://doi.org/10.1038/s41416-023-02467-9 |
| URL: | https://www.nature.com/articles/s41416-023-02467-9.pdf |
Publication 9329
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Abstract
BackgroundIn the United Kingdom (UK), cancer screening invitations are based on general practice (GP) registrations. We hypothesize that GP electronic medical records (EMR) can be utilised to calculate a lung cancer risk score with good accuracy/clinical utility.MethodsThe development cohort was Secure Anonymised Information Linkage-SAIL (2.3 million GP EMR) and the validation cohort was UK Biobank-UKB (N = 211,597 with GP-EMR availability). Fast backward method was applied for variable selection and area under the curve (AUC) evaluated discrimination.ResultsAge 55-75 were included (SAIL: N = 574,196; UKB: N = 137,918). Six-year lung cancer incidence was 1.1% (6430) in SAIL and 0.48% (656) in UKB. The final model included 17/56 variables in SAIL for the EMR-derived score: age, sex, socioeconomic status, smoking status, family history, body mass index (BMI), BMI:smoking interaction, alcohol misuse, chronic obstructive pulmonary disease, coronary heart disease, dementia, hypertension, painful condition, stroke, peripheral vascular disease and history of previous cancer and previous pneumonia. The GP-EMR-derived score had AUC of 80.4% in SAIL and 74.4% in UKB and outperformed ever-smoked criteria (currently the first step in UK lung cancer screening pilots).DiscussionA GP-EMR-derived score may have a role in UK lung cancer screening by accurately targeting high-risk individuals without requiring patient contact.</p>
10 Authors
- Bhautesh Dinesh Jani
- Michael K. Sullivan
- Peter Hanlon
- Barbara I. Nicholl
- Jennifer S. Lees
- Lamorna Brown
- Sara MacDonald
- Patrick B. Mark
- Frances S. Mair
- Frank M. Sullivan
1 Application
| Application ID | Title |
|---|---|
| 14151 | Exploring multimorbidity in UK Biobank ? patterns of illness reporting and effects of comorbidity and multimorbidity on health outcomes |
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