Journal article
Full BLOOD count TRends for colorectal cAnCer deteCtion (BLOODTRACC): external validation of dynamic clinical prediction models for early detection of colorectal cancer in primary care
- Abstract:
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Background: Colorectal cancer has low survival rates when diagnosed late-stage. We previously developed sexspecific dynamic risk prediction models utilising trends in the full blood count (FBC), a blood test commonly performed in primary care, to support early detection. We aimed
Methods: We performed a cohort study of patients with at least one haemoglobin, mean cell volume, and platelet test. Patients were aged at least 40 years at their current test and had no history of colorectal cancer. The models included age (years) at current test and simultaneous trends over historical tests measured over five years before the current test to inform two-year risk of colorectal cancer diagnosis. Performance measures included the c-statistic and calibration slope.to externally validate these prediction models.
Results: We included 2,956,977 males and 3,561,349 females, with 0.4% (n=12,578) and 0.3% (n=11,939) diagnosed with colorectal cancer, respectively. The c-statistic (95% CI) was 0.73 (0.72-0.73) for males and 0.74 (0.74-0.75) for females. The calibration slope (95% CI) was 0.92 (0.89-0.94) for males and 0.95 (0.93-0.98) for females. Calibration was good in subgroups of patient data, except underpredicted risk in those aged 70+ years, White individuals, and those with higher IMD. The c-statistic (95% CI) was similar regardless of the number of repeat tests used to define trend and increased as the longitudinal trend window increased until around 2.5-3.0 years for men (0.73 (0.71-0.74)) and 3.0-3.5 years for women (0.73 (0.72-0.75)) and decreased with increasing longitudinal windows thereafter.
Conclusion: Utilising temporal changes in the commonly performed FBC test could enhance risk stratification for colorectal cancer in primary care. Further research may highlight approaches for improving predictive performance further.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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- Files:
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(Preview, Accepted manuscript, pdf, 1.2MB, Terms of use)
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- Publisher copy:
- 10.1186/s12885-026-16179-9
Authors
- Publisher:
- Springer
- Journal:
- BMC Cancer More from this journal
- Publication date:
- 2026-05-14
- Acceptance date:
- 2026-05-11
- DOI:
- EISSN:
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1471-2407
- Language:
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English
- Keywords:
- Pubs id:
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2418683
- Local pid:
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pubs:2418683
- Deposit date:
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2026-05-11
- ARK identifier:
Terms of use
- Copyright holder:
- Virdee et al.
- Copyright date:
- 2026
- Rights statement:
- Copyright © 2026, The Author(s). This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
- Licence:
- CC Attribution (CC BY)
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