TY  - JOUR
VL  - 129
UR  - https://eprints.gla.ac.uk/308155/
Y1  - 2023/12/07/
A1  - Jani, Bhautesh Dinesh
A1  - Sullivan, Michael K.
A1  - Hanlon, Peter
A1  - Nicholl, Barbara I.
A1  - Lees, Jennifer S.
A1  - Brown, Lamorna
A1  - MacDonald, Sara
A1  - Mark, Patrick B.
A1  - Mair, Frances S.
A1  - Sullivan, Frank M.
SN  - 0007-0920
SP  - 1968
TI  - Personalised lung cancer risk stratification and lung cancer screening: do general practice electronic medical records have a role?
JF  - British Journal of Cancer
EP  - 1977
AV  - public
PB  - Springer Nature
IS  - 12
N2  - Background: 
In the United Kingdom (UK), cancer screening invitations are based on general practice (GP) registrations. We hypothesize that GP electronic medical records (EMR) can be utilised to calculate a lung cancer risk score with good accuracy/clinical utility.

Methods: 
The development cohort was Secure Anonymised Information Linkage-SAIL (2.3 million GP EMR) and the validation cohort was UK Biobank-UKB (N?=?211,597 with GP-EMR availability). Fast backward method was applied for variable selection and area under the curve (AUC) evaluated discrimination.

Results: 
Age 55?75 were included (SAIL: N?=?574,196; UKB: N?=?137,918). Six-year lung cancer incidence was 1.1% (6430) in SAIL and 0.48% (656) in UKB. The final model included 17/56 variables in SAIL for the EMR-derived score: age, sex, socioeconomic status, smoking status, family history, body mass index (BMI), BMI:smoking interaction, alcohol misuse, chronic obstructive pulmonary disease, coronary heart disease, dementia, hypertension, painful condition, stroke, peripheral vascular disease and history of previous cancer and previous pneumonia. The GP-EMR-derived score had AUC of 80.4% in SAIL and 74.4% in UKB and outperformed ever-smoked criteria (currently the first step in UK lung cancer screening pilots).

Discussion: 
A GP-EMR-derived score may have a role in UK lung cancer screening by accurately targeting high-risk individuals without requiring patient contact.
ID  - enlighten308155
N1  - Dr Bhautesh Dinesh Jani?s time was partly funded by a research grant from the British Medical Association. Chief Scientist Office (CSO, Scotland) funded SAIL data access costs (PCL/18/03). JSL was funded by a via a CSO Postdoctoral Lectureship Award (PCL/20/10). The Medical Research Council fund MKS (MR/V001671/1) and PH (MR/S021949/1).
ER  -