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Development and external validation of a head and neck cancer risk prediction model

Lookup NU author(s): Dr Max RobinsonORCiD, Dr Paul Brennan

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC. Background: Head and neck cancer (HNC) incidence is on the rise, often diagnosed at late stage and associated with poor prognoses. Risk prediction tools have a potential role in prevention and early detection. Methods: The IARC-ARCAGE European case–control study was used as the model development dataset. A clinical HNC risk prediction model using behavioral and demographic predictors was developed via multivariable logistic regression analyses. The model was then externally validated in the UK Biobank cohort. Model performance was tested using discrimination and calibration metrics. Results: 1926 HNC cases and 2043 controls were used for the development of the model. The development dataset model including sociodemographic, smoking, and alcohol variables had moderate discrimination, with an area under curve (AUC) value of 0.75 (95% CI, 0.74–0.77); the calibration slope (0.75) and tests were suggestive of good calibration. 384 616 UK Biobank participants (with 1177 HNC cases) were available for external validation of the model. Upon external validation, the model had an AUC of 0.62 (95% CI, 0.61–0.64). Conclusion: We developed and externally validated a HNC risk prediction model using the ARCAGE and UK Biobank studies, respectively. This model had moderate performance in the development population and acceptable performance in the validation dataset. Demographics and risk behaviors are strong predictors of HNC, and this model may be a helpful tool in primary dental care settings to promote prevention and determine recall intervals for dental examination. Future addition of HPV serology or genetic factors could further enhance individual risk prediction.


Publication metadata

Author(s): Smith CDL, McMahon AD, Lyall DM, Goulart M, Inman GJ, Ross A, Gormley M, Dudding T, Macfarlane GJ, Robinson M, Richiardi L, Serraino D, Polesel J, Canova C, Ahrens W, Healy CM, Lagiou P, Holcatova I, Alemany L, Znoar A, Waterboer T, Brennan P, Virani S, Conway DI

Publication type: Article

Publication status: Published

Journal: Head and Neck

Year: 2024

Pages: ePub ahead of Print

Online publication date: 08/06/2024

Acceptance date: 26/05/2024

Date deposited: 25/06/2024

ISSN (print): 1043-3074

ISSN (electronic): 1097-0347

Publisher: John Wiley and Sons Inc.

URL: https://doi.org/10.1002/hed.27834

DOI: 10.1002/hed.27834

PubMed id: 38850089


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Funding

Funder referenceFunder name
Cancer Research UK
Cancer Research UK (Grant No. 315941-01)
Compagnia San Paolo, AIRC
European Community (5th Framework Programme) (Grant No. QLK1-CT-2001-00182)
MRC
National Health Service (NHS)
NIHR
Wellcome Trust
University of Athens Medical School

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