AI Tool Predicts Certain GI Cancers Years in Advance

Health News

TOPLINE:

The Kettles Esophageal and Cardia Adenocarcinoma predictioN (K-ECAN) tool predicts esophageal adenocarcinoma (EAC) and gastric cardia adenocarcinoma (GCA) using data from the electronic health record (EHR) and is more accurate than other tools, a large study suggests.

METHODOLOGY:

Researchers performed a case-control study using data from the Veterans Health Administration (VHA) Central Cancer Registry.
They identified 8430 patients with EAC and 2965 patients GCA; these patients were compared with more than 10 million control patients.
K-ECAN uses basic information in the EHR to determine an individual’s future risk of developing EAC or GCA.

TAKEAWAY:

With an area under the receiver operating characteristic (AUROC) of 0.77, K-ECAN demonstrated better discrimination than previously validated models and published guidelines.
Using only data from 3 to 5 years prior to diagnosis only slightly diminished its accuracy (AUROC, 0.75).
K-ECAN remained the most accurate tool when undersampling men to simulate a non-VHA population (AUROC, 0.85).
Although gastroesophageal reflux disease (GERD) was strongly associated with EAC, it only contributed a small proportion of gain in information for prediction.

IN PRACTICE:

Because K-ECAN does not rely heavily on GERD symptoms to assess risk, it has the “potential to guide providers to increase appropriate uptake of screening. De-emphasizing GERD in decisions to offer screening could paradoxically increase appropriate uptake of screening for EAC and GCA,” the authors write.

SOURCE:

The study, with first author Joel H. Rubenstein, MD, with the LTC Charles S. Kettles VA Medical Center, Ann Arbor, Michigan, was published online August 17 in Gastroenterology.

LIMITATIONS:

K-ECAN was developed and validated among US veterans and needs to be validated in other populations.

DISCLOSURES:

Funding for the study was provided by the US Department of Defense. Rubenstein has received research support from Lucid Diagnostics.

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