New Oxford and Nottingham developed tool uses existing health records to predict people’s risk of developing lung cancer within the next 10 years.
5 April 2023
A team of researchers from the University of Oxford and the University of Nottingham have developed a new tool, called ‘CanPredict’, able to identify the people most at risk of developing lung cancer over the next 10 years, and put them forward for screening tests earlier, saving time, money and, most importantly, lives.
Writing today in the journal Lancet Respiratory Medicine, the researchers developed and tested the tool using the anonymised health records of over 19 million adults from across the UK.
Lung cancer is the second most common cancer in incidence and the leading cause of cancer deaths worldwide. However, lung cancer screening – ‘catching it early’ – has been shown to improve survival rates. Because of this, in September 2022 the UK National Screening Committee recommended using targeted lung cancer screening. However, the committee did not recommend which tools would best be used for targeting screening at people most at risk.
Professor Fergus Gleeson, co-author of the study and Professor of Radiology in the Department of Oncology at the University of Oxford, said:
Around 48,500 people are diagnosed with lung cancer each year in the UK. In its early stages, there are usually no obvious signs or symptoms, and it can go undetected for some time. Using a technique called low-dose computerised tomography (CT) for lung cancer screening we can catch this disease and treat it earlier, and that improves people’s outcomes.
However, this type of screening isn’t something we can do en masse for the population, we need a way to target those at the greatest risk and put them forward for screening.
Current methods to target screening rely on doctors recognising high-risk individuals or using tools based on using patient questionnaires to score risk and put those at highest forward.
Dr Weiqi Liao, lead author on the publication and a data scientist in the Nuffield Department of Primary Care Health Sciences, University of Oxford, said:
Our tool, CanPredict, works by examining existing patient health records, so it could be run on a per GP surgery basis or nationally, automatically and objectively prioritising patients and alerting their GPs that they might benefit from further screening.
Because of this, CanPredict has the potential to substantially reduce the burden on NHS staff, saving time, money and streamlining the administrative process for better patient experience.
To develop the new tool the researchers used two separate sets of health record data. Using the QResearch Database (which, in total, contains the anonymised health records of over 35 million patients, spanning all ethnicities and social groups across the UK) to identify 13 million people aged between 25 to 84 among whom 73,380 had a diagnosis of lung cancer. They then looked back through their health records to identify common factors which might be used to statistically predict their risk of developing the cancer. Factors such as smoking, age, ethnicity, body mass index, medical conditions and social deprivation (and others) were considered as part of the analysis.
Once the tool was developed, the researchers needed to test it. They did this using a separate set of anonymised GP health records – the Clinical Practice Research Datalink (CPRD).
The researchers used the CPRD data (which contained data from an additional 2.54 million people’s anonymised health records) to see which people their new tool predicted were at the greatest risk of developing lung cancer, and then compared this to those who did go on to develop lung cancer.
The new CanPredict tool correctly identified more people who went on to develop lung cancer and was more sensitive than current recommended methods of predicting risk, across 5-, 6-, and 10-year forecasts.
Professor Julia Hippisley-Cox, senior author and Professor of Clinical Epidemiology and General Practice and the Nuffield Department of Primary Care Health Sciences, University of Oxford, said:
Improving early diagnosis of lung cancer is incredibly important both for the NHS but especially for patients and their families. We hope that this new validated risk tool will help better prioritise patients for screening and ultimately help spot lung cancer earlier when treatments are more likely to help. We’d like to thank the many thousands of GPs who have shared anonymised data for research without whom this would not have been possible.
The researchers plan to make the tool publicly available for use, subject to further funding for implementation in day-to-day practice and to ensure Medicines and Healthcare Products Regulatory Agency (MHRA) medical device compliance.
Notes to editors:
Predicting the future risk of lung cancer: development, and internal and external validation of the CanPredict (lung) model in 19·67 million people and evaluation of model performance against seven other risk prediction models
Weiqi Liao, Carol A C Coupland, Judith Burchardt, David R Baldwin, collaborators of the DART initiative*, Fergus V Gleeson, Julia Hippisley-Cox. (2023), The Lancet Respiratory Medicine
This research, part of the DART (The Integration and Analysis of Data using Artificial Intelligence to Improve Patient Outcomes with Thoracic Diseases) project, is funded by Innovate UK (UK Research and Innovation, grant reference: 40255). QResearch® received funding from the NIHR Biomedical Research Centre (Oxford), John Fell Oxford University Press Research Fund, Cancer Research UK (Grant number C5255/A18085), through the Cancer Research UK Oxford Centre, the Oxford Wellcome Institutional Strategic Support Fund (204826/Z/16/Z).
Contact for media calls
For all press enquiries, please contact firstname.lastname@example.org (including out of hours).
About the University of Oxford
Oxford University has been placed number one in the Times Higher Education World University Rankings for the sixth year running, and second in the QS World Rankings 2022. At the heart of this success is our ground-breaking research and innovation.
Oxford is world-famous for research excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research sparks imaginative and inventive insights and solutions.
Oxford University’s Medical Sciences Division is one of the largest biomedical research centres in Europe, with over 2,500 people involved in research and more than 2,800 students. The University is rated the best in the world for medicine and life sciences, and it is home to the UK’s top-ranked medical school. It has one of the largest clinical trial portfolios in the UK and great expertise in taking discoveries from the lab into the clinic. Partnerships with the local NHS Trusts enable patients to benefit from close links between medical research and healthcare delivery.
Within the division, the Nuffield Department of Primary Care Health Sciences is the largest centre for academic primary care in the UK and leads world-class research and training to rethink the way healthcare is delivered in general practice and other primary care settings. The department’s main research focus is on the prevention, early diagnosis, and management of common illness, bringing together academics from many different backgrounds to work together to produce benefits for the NHS, for populations, and for patients (www.phc.ox.ac.uk).