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An evaluation of the prognostic model PREDICT using the POSH cohort of women aged ⩽40 years at breast cancer diagnosis

An evaluation of the prognostic model PREDICT using the POSH cohort of women aged ⩽40 years at breast cancer diagnosis
An evaluation of the prognostic model PREDICT using the POSH cohort of women aged ⩽40 years at breast cancer diagnosis

BACKGROUND: Breast cancer is the most common cancer in younger women (aged ⩽40 years) in the United Kingdom. PREDICT (http://www.predict.nhs.uk) is an online prognostic tool developed to help determine the best available treatment and outcome for early breast cancer. This study was conducted to establish how well PREDICT performs in estimating survival in a large cohort of younger women recruited to the UK POSH study.

METHODS: The POSH cohort includes data from 3000 women aged ⩽40 years at breast cancer diagnosis. Study end points were overall and breast cancer-specific survival at 5, 8, and 10 years. Evaluation of PREDICT included model discrimination and comparison of the number of predicted versus observed events.

RESULTS: PREDICT provided accurate long-term (8- and 10-year) survival estimates for younger women. Five-year estimates were less accurate, with the tool overestimating survival by 25% overall, and by 56% for patients with oestrogen receptor (ER)-positive tumours. PREDICT underestimated survival at 5 years among patients with ER-negative tumours.

CONCLUSIONS: PREDICT is a useful tool for providing reliable long-term (10-year) survival estimates for younger patients. However, for more accurate short-term estimates, the model requires further calibration using more data from young onset cases. Short-term prediction may be most relevant for the increasing number of women considering risk-reducing bilateral mastectomy.

Adolescent, Adult, Age Factors, Breast Neoplasms, Female, Humans, Models, Statistical, Prognosis, Receptors, Estrogen, United Kingdom, Young Adult, Journal Article, Research Support, Non-U.S. Gov't
0007-0920
983-991
Maishman, T.
cf4259a4-0eef-4975-9c9d-a2c3d594f989
Copson, E.
a94cdbd6-f6e2-429d-a7c0-462c7da0e92b
Stanton, L.
8b827763-d839-4b4b-bbf2-358a84110294
Gerty, S.
b2013815-27c9-4a7d-ad42-071f60a8000f
Dicks, E.
251d91cb-f282-4002-af27-36a341b48a2c
Durcan, L.
bd059b41-9e77-4afe-b271-9ac4c91a05c6
Wishart, G.C.
f66cd4e0-e16f-4a97-b629-d11f4166d509
Pharoah, P.
59a5f56d-1152-4b6d-8c1e-4007802e1bdb
Eccles, D.
5b59bc73-11c9-4cf0-a9d5-7a8e523eee23
Maishman, T.
cf4259a4-0eef-4975-9c9d-a2c3d594f989
Copson, E.
a94cdbd6-f6e2-429d-a7c0-462c7da0e92b
Stanton, L.
8b827763-d839-4b4b-bbf2-358a84110294
Gerty, S.
b2013815-27c9-4a7d-ad42-071f60a8000f
Dicks, E.
251d91cb-f282-4002-af27-36a341b48a2c
Durcan, L.
bd059b41-9e77-4afe-b271-9ac4c91a05c6
Wishart, G.C.
f66cd4e0-e16f-4a97-b629-d11f4166d509
Pharoah, P.
59a5f56d-1152-4b6d-8c1e-4007802e1bdb
Eccles, D.
5b59bc73-11c9-4cf0-a9d5-7a8e523eee23

Maishman, T., Copson, E., Stanton, L., Gerty, S., Dicks, E., Durcan, L., Wishart, G.C., Pharoah, P. and Eccles, D. (2015) An evaluation of the prognostic model PREDICT using the POSH cohort of women aged ⩽40 years at breast cancer diagnosis. British Journal of Cancer, 112 (6), 983-991. (doi:10.1038/bjc.2015.57). (PMID:11181660)

Record type: Article

Abstract

BACKGROUND: Breast cancer is the most common cancer in younger women (aged ⩽40 years) in the United Kingdom. PREDICT (http://www.predict.nhs.uk) is an online prognostic tool developed to help determine the best available treatment and outcome for early breast cancer. This study was conducted to establish how well PREDICT performs in estimating survival in a large cohort of younger women recruited to the UK POSH study.

METHODS: The POSH cohort includes data from 3000 women aged ⩽40 years at breast cancer diagnosis. Study end points were overall and breast cancer-specific survival at 5, 8, and 10 years. Evaluation of PREDICT included model discrimination and comparison of the number of predicted versus observed events.

RESULTS: PREDICT provided accurate long-term (8- and 10-year) survival estimates for younger women. Five-year estimates were less accurate, with the tool overestimating survival by 25% overall, and by 56% for patients with oestrogen receptor (ER)-positive tumours. PREDICT underestimated survival at 5 years among patients with ER-negative tumours.

CONCLUSIONS: PREDICT is a useful tool for providing reliable long-term (10-year) survival estimates for younger patients. However, for more accurate short-term estimates, the model requires further calibration using more data from young onset cases. Short-term prediction may be most relevant for the increasing number of women considering risk-reducing bilateral mastectomy.

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More information

e-pub ahead of print date: 12 February 2015
Published date: 17 March 2015
Keywords: Adolescent, Adult, Age Factors, Breast Neoplasms, Female, Humans, Models, Statistical, Prognosis, Receptors, Estrogen, United Kingdom, Young Adult, Journal Article, Research Support, Non-U.S. Gov't
Organisations: Statistics, Faculty of Medicine, Clinical Trials Unit

Identifiers

Local EPrints ID: 376059
URI: http://eprints.soton.ac.uk/id/eprint/376059
ISSN: 0007-0920
PURE UUID: d0a7793a-ba9a-4d62-a373-f9c833c7450c
ORCID for L. Stanton: ORCID iD orcid.org/0000-0001-8181-840X
ORCID for D. Eccles: ORCID iD orcid.org/0000-0002-9935-3169

Catalogue record

Date deposited: 23 Apr 2015 10:08
Last modified: 19 Feb 2021 02:33

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