Development and Validation of a Multiparameterized Artificial Neural Network for Prostate Cancer Risk Prediction and Stratification.

PURPOSE

To develop and validate a multiparameterized artificial neural network (ANN) on the basis of personal health information for prostate cancer risk prediction and stratification.

METHODS

The 1997 to 2015 National Health Interview Survey adult survey data were used to train and validate a multiparameterized ANN, with parameters including age, body mass index, diabetes status, smoking status, emphysema, asthma, race, ethnicity, hypertension, heart disease, exercise habits, and history of stroke. We developed a training set of patients ≥ 45 years of age with a first primary prostate cancer diagnosed within 4 years of the survey. After training, the sensitivity and specificity were obtained as functions of the cutoff values of the continuous output of the ANN. We also evaluated the ANN with the 2016 data set for cancer risk stratification.

RESULTS

We identified 1,672 patients with prostate cancer and 100,033 respondents without cancer in the 1997 to 2015 data sets. The training set had a sensitivity of 21.5% (95% CI, 19.2% to 23.9%), specificity of 91% (95% CI, 90.8% to 91.2%), area under the curve of 0.73 (95% CI, 0.71 to 0.75), and positive predictive value of 28.5% (95% CI, 25.5% to 31.5%). The validation set had a sensitivity of 23.2% (95% CI, 19.5% to 26.9%), specificity of 89.4% (95% CI, 89% to 89.7%), area under the curve of 0.72 (95% CI, 0.70 to 0.75), and positive predictive value of 26.5% (95% CI, 22.4% to 30.6%). For the 2016 data set, the ANN classified all 13,031 patients into low-, medium-, and high-risk subgroups and identified 5% of the cancer population as high risk.

CONCLUSION

A multiparameterized ANN that is based on personal health information could be used for prostate cancer risk prediction with high specificity and low sensitivity. The ANN can further stratify the population into three subgroups that may be helpful in refining prescreening estimates of cancer risk.