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Open Access 25-04-2024 | Colorectal Cancer | Original Article

Development and Validation of a Colorectal Cancer Prediction Model: A Nationwide Cohort-Based Study

Authors: Ofer Isakov, Dan Riesel, Michael Leshchinsky, Galit Shaham, Ben Y. Reis, Dan Keret, Zohar Levi, Baruch Brener, Ran Balicer, Noa Dagan, Samah Hayek

Published in: Digestive Diseases and Sciences

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Abstract

Background

Early diagnosis of colorectal cancer (CRC) is critical to increasing survival rates. Computerized risk prediction models hold great promise for identifying individuals at high risk for CRC. In order to utilize such models effectively in a population-wide screening setting, development and validation should be based on cohorts that are similar to the target population.

Aim

Establish a risk prediction model for CRC diagnosis based on electronic health records (EHR) from subjects eligible for CRC screening.

Methods

A retrospective cohort study utilizing the EHR data of Clalit Health Services (CHS). The study includes CHS members aged 50–74 who were eligible for CRC screening from January 2013 to January 2019. The model was trained to predict receiving a CRC diagnosis within 2 years of the index date. Approximately 20,000 EHR demographic and clinical features were considered.

Results

The study includes 2935 subjects with CRC diagnosis, and 1,133,457 subjects without CRC diagnosis. Incidence values of CRC among subjects in the top 1% risk scores were higher than baseline (2.3% vs 0.3%; lift 8.38; P value < 0.001). Cumulative event probabilities increased with higher model scores. Model-based risk stratification among subjects with a positive FOBT, identified subjects with more than twice the risk for CRC compared to FOBT alone.

Conclusions

We developed an individualized risk prediction model for CRC that can be utilized as a complementary decision support tool for healthcare providers to precisely identify subjects at high risk for CRC and refer them for confirmatory testing.
Appendix
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Metadata
Title
Development and Validation of a Colorectal Cancer Prediction Model: A Nationwide Cohort-Based Study
Authors
Ofer Isakov
Dan Riesel
Michael Leshchinsky
Galit Shaham
Ben Y. Reis
Dan Keret
Zohar Levi
Baruch Brener
Ran Balicer
Noa Dagan
Samah Hayek
Publication date
25-04-2024
Publisher
Springer US
Published in
Digestive Diseases and Sciences
Print ISSN: 0163-2116
Electronic ISSN: 1573-2568
DOI
https://doi.org/10.1007/s10620-024-08427-4
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