• Family practice · Dec 2023

    Validation of a diagnostic prediction tool for colorectal cancer: a case-control replication study.

    • Elinor Nemlander, Andreas Rosenblad, Eliya Abedi, Jan Hasselström, Annika Sjövall, Axel C Carlsson, and Marcela Ewing.
    • Department of Neurobiology, Care Sciences and Society, Division of Family Medicine and Primary Care, Karolinska Institutet, Solna, Sweden.
    • Fam Pract. 2023 Dec 22; 40 (5-6): 844851844-851.

    BackgroundEarly detection of colorectal cancer (CRC) is crucial for survival. Primary care, the first point of contact in most cases, needs supportive risk assessment tools. We aimed to replicate the Swedish Colorectal Cancer Risk Assessment Tool (SCCRAT) for non-metastatic CRC in primary care and examine if risk factor patterns depend on sex and age.Methods2,920 adults diagnosed with non-metastatic CRC during the years 2015-2019 after having visited a general practitioner the year before the diagnosis were selected from the Swedish Cancer Register and matched with 11,628 controls, using the same inclusion criteria except for the CRC diagnosis. Diagnostic codes from primary care consultations were collected from a regional health care database. Positive predictive values (PPVs) were estimated for the same 5 symptoms and combinations thereof as in the baseline study.ResultsThe results for patients aged ≥50 years old in the present study were consistent with the results of the SCCRAT study. All symptoms and combinations thereof with a PPV >5% in the present study had a PPV >5% in the baseline study. The combination of bleeding with abdominal pain (PPV 9.9%) and bleeding with change in bowel habit (PPV 7.8%) were the highest observed PPVs in both studies. Similar risk patterns were seen for all ages and when men and women were studied separately.ConclusionThis external validation of the SCCRAT for non-metastatic CRC in primary care replicated the baseline study successfully and identified patients at high risk for CRC.© The Author(s) 2023. Published by Oxford University Press.

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