Department of Biostatistics, The University of Texas MD Anderson Cancer Center, Houston, USA.
Sci Rep. 2023 Aug 17;13(1):13382. doi: 10.1038/s41598-023-40415-y.
Prognostic models in cancer use patient demographic and tumor characteristics to predict survival and dynamic disease prognosis. Past work in breast cancer has shown that cancer detection method, screen-detected or symptom-detected, has prognostic significance. We investigate this phenomenon in the lung component of the Prostate, Lung, Colorectal, and Ovarian (PLCO) screening trial. Patients were randomized to intervention, receiving four annual chest x-rays (CXRs), or to control, receiving usual care. Patients were followed for a total of approximately 13 years. In PLCO, lung cancer detection method has independent prognostic value exceeding that of variables commonly used in lung cancer prognostic models, including sex, histology, and age. Results are robust to cohort selection and type of predictive model. These results imply that detection method should be considered when developing prognostic models in lung cancer studies, and cancer registries should routinely collect cancer detection method.
癌症预后模型利用患者的人口统计学和肿瘤特征来预测生存和疾病的动态预后。过去的乳腺癌研究表明，癌症的检测方法（筛查发现或症状发现）具有预后意义。我们在前列腺癌、肺癌、结直肠癌和卵巢癌（PLCO）筛查试验的肺部部分研究了这一现象。患者被随机分配到干预组，接受每年四次胸部 X 光检查（CXR），或对照组，接受常规护理。患者总共随访了大约 13 年。在 PLCO 中，肺癌的检测方法具有独立的预后价值，超过了常用于肺癌预后模型的变量，包括性别、组织学和年龄。这些结果在队列选择和预测模型类型上都是稳健的。这些结果表明，在肺癌研究中开发预后模型时应考虑检测方法，并且癌症登记处应常规收集癌症检测方法。
