Development and External Validation of Partial Proportional Odds Risk Prediction Models for Cancer Stage at Diagnosis among Males and Females in Canada

Timofei Biziaev, Michelle L. Aktary, Qinggang Wang, Thierry Chekouo, Parveen Bhatti, Lorraine Shack, Paula J. Robson, Karen A. Kopciuk

Research output: Contribution to journalArticlepeer-review

Abstract

Risk prediction models for cancer stage at diagnosis may identify individuals at higher risk of late-stage cancer diagnoses. Partial proportional odds risk prediction models for cancer stage at diagnosis for males and females were developed using data from Alberta’s Tomorrow Project (ATP). Prediction models were validated on the British Columbia Generations Project (BCGP) cohort using discrimination and calibration measures. Among ATP males, older age at diagnosis was associated with an earlier stage at diagnosis, while full- or part-time employment, prostate-specific antigen testing, and former/current smoking were associated with a later stage at diagnosis. Among ATP females, mammogram and sigmoidoscopy or colonoscopy were associated with an earlier stage at diagnosis, while older age at diagnosis, number of pregnancies, and hysterectomy were associated with a later stage at diagnosis. On external validation, discrimination results were poor for both males and females while calibration results indicated that the models did not over- or under-fit to derivation data or over- or under-predict risk. Multiple factors associated with cancer stage at diagnosis were identified among ATP participants. While the prediction model calibration was acceptable, discrimination was poor when applied to BCGP data. Updating our models with additional predictors may help improve predictive performance.

Original languageEnglish (US)
Article number3545
JournalCancers
Volume15
Issue number14
DOIs
StatePublished - Jul 2023

Bibliographical note

Publisher Copyright:
© 2023 by the authors.

Keywords

  • Alberta’s Tomorrow Project
  • British Columbia Generations Project
  • calibration
  • cancer stage at diagnosis
  • discrimination
  • external validation

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