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One-year mortality of colorectal cancer patients: development and validation of a prediction model using linked national electronic data.

Published version
Peer-reviewed

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Authors

Bellot, Alexis 
Boyle, Jemma 
Walker, Kate 
Kuryba, Angela 

Abstract

BACKGROUND: The existing literature does not provide a prediction model for mortality of all colorectal cancer patients using contemporary national hospital data. We developed and validated such a model to predict colorectal cancer death within 90, 180 and 365 days after diagnosis. METHODS: Cohort study using linked national cancer and death records. The development population included 27,480 patients diagnosed in England in 2015. The test populations were diagnosed in England in 2016 (n = 26,411) and Wales in 2015-2016 (n = 3814). Predictors were age, gender, socioeconomic status, referral source, performance status, tumour site, TNM stage and treatment intent. Cox regression models were assessed using Brier scores, c-indices and calibration plots. RESULTS: In the development population, 7.4, 11.7 and 17.9% of patients died from colorectal cancer within 90, 180 and 365 days after diagnosis. T4 versus T1 tumour stage had the largest adjusted association with the outcome (HR 4.67; 95% CI: 3.59-6.09). C-indices were 0.873-0.890 (England) and 0.856-0.873 (Wales) in the test populations, indicating excellent separation of predicted risks by outcome status. Models were generally well calibrated. CONCLUSIONS: The model was valid for predicting short-term colorectal cancer mortality. It can provide personalised information to support clinical practice and research.

Description

Funder: The National Bowel Cancer Audit is commissioned by the Healthcare Quality Improvement Partnership (HQIP) as part of the National Clinical Audit and Patient Outcomes Programme, and funded by NHS England and the Welsh Government (www.hqip.org.uk/national-programmes).

Keywords

Adolescent, Adult, Aged, Aged, 80 and over, Colorectal Neoplasms, Electronic Health Records, England, Female, Follow-Up Studies, Humans, Male, Medical Record Linkage, Middle Aged, Mortality, Prognosis, Proportional Hazards Models, Risk Assessment, Socioeconomic Factors, Survival Analysis, Wales, Young Adult

Journal Title

Br J Cancer

Conference Name

Journal ISSN

0007-0920
1532-1827

Volume Title

123

Publisher

Springer Science and Business Media LLC
Sponsorship
RCUK | Medical Research Council (MRC) (MR/S020470/1)