title: Identifying women with undetected ovarian cancer: independent and external validation of QCancer(®) (Ovarian) prediction model.
abstract: Early identification of ovarian cancer is an unresolved challenge and the predictive value of single symptoms is limited. We evaluated the performance of QCancer(®) (Ovarian) prediction model for predicting the risk of ovarian cancer in a UK cohort of general practice patients. A total of 1.1 million patients registered with a general practice surgery between 1 January 2000 and 30 June 2008, aged 30-84 years with 735 ovarian cancer cases, were included in the analysis. Ovarian cancer was defined as incident diagnosis of ovarian cancer during the 2 years after study entry. The results from this independent and external validation of QCancer(®) (Ovarian) prediction model demonstrated good performance on a large cohort of general practice patients. QCancer(®) (Ovarian) had very good discrimination with an area under the receiver operating characteristic curve of 0.86 and explained 59.9% of the variation. QCancer(®) (Ovarian) was well calibrated across all tenths of risk and over all age. The 10% of women with the highest predicted risks included 64% of all ovarian cancer diagnoses over the next 2 years. QCancer(®) (Ovarian) appears to be a useful tool for identifying undetected cases of ovarian cancer in primary care in the UK for early referral and investigation.
authors.affiliation: Centre for Statistics in Medicine, Wolfson College Annexe, University of Oxford, Oxford, UK. gary.collins@csm.ox.ac.uk
authors.forename: G S
authors.initials: GS
authors.lastname: Collins
authors.forename: D G
authors.initials: DG
authors.lastname: Altman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D058006:General Practice / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D008954:Models, Biological; D010051:Ovarian Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D011237:Predictive Value of Tests; D011320:Primary Health Care / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D006113:United Kingdom / Q000453:epidemiology