Identifying patients with undetected gastro-oesophageal cancer in primary care: External validation of QCancer® (Gastro-Oesophageal)

Eur J Cancer. 2013 Mar;49(5):1040-8. doi: 10.1016/j.ejca.2012.10.023. Epub 2012 Nov 15.

Abstract

Objective: To evaluate the performance of QCancer® (Gastro-Oesophageal) for predicting the risk of undiagnosed gastro-oesophageal cancer in an independent UK cohort of patients from general practice records.

Design: Open cohort study to validate QCancer® (Gastro-Oesophageal) prediction model. Three hundred sixty-five practices from the United Kingdom contributing to The Health Improvement Network database. 2.1 million patients registered with a general practice surgery between 01 January 2000 and 30 June 2008, aged 30-84years (3.7 million person years) with 1766 gastro-oesophageal cancer cases. The outcome, gastro-oesophageal cancer was defined as incident diagnosis of gastro-oesophageal cancer during the 2years after study entry.

Results: The results from this independent and external validation of QCancer® (Gastro-Oesophageal) demonstrated good performance data on a large cohort of general practice patients. QCancer® (Gastro-Oesophageal) had very good discrimination with c-statistics of 0.93 and 0.94 for women and men respectively. QCancer® (Gastro-Oesophageal) was well calibrated across all tenths of risk and over all age ranges with predicted risks closely matching observed risks. QCancer® (Gastro-Oesophageal) explained 74.4% and 75.6% of the variation in men and women respectively.

Conclusions: QCancer® (Gastro-Oesophageal) is a useful tool to identify undiagnosed gastro-oesophageal cancer in primary care in the United Kingdom.

Publication types

  • Evaluation Study
  • Validation Study

MeSH terms

  • Adult
  • Aged
  • Cohort Studies
  • Delayed Diagnosis / statistics & numerical data
  • Diagnostic Errors / statistics & numerical data*
  • Early Detection of Cancer / methods*
  • Early Detection of Cancer / standards
  • Esophageal Neoplasms / diagnosis*
  • Esophageal Neoplasms / epidemiology
  • General Practice / statistics & numerical data
  • Humans
  • Incidence
  • Middle Aged
  • Predictive Value of Tests
  • Primary Health Care / statistics & numerical data*
  • Prognosis
  • Risk
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / epidemiology
  • United Kingdom / epidemiology