Risk prediction calculators are already routinely used to estimate a person’s risk of developing cardiovascular disease based on factors such as BMI, age and smoking status. But many of these factors also increase the risk of developing cancer.
New research published in the European Journal of Cancer and supported by HDR UK’s Big Data for Complex Disease programme reveals that when repurposed, tools used to predict risk for cardiovascular disease can perform just as well or better at predicting certain types of cancer.
The study looked at four similar tools used to assess heart disease and stroke risk: QRISK3, the Pooled Cohort Equations, SCORE2 and SCORE2-OP. Through analysing data from over five million people, researchers compared what the models predicted against actual rates of heart disease and cancer in people aged 40 to 84 over a 10-year period.
The cardiovascular prediction tools were found to estimate the risk of common cancer types – including prostate, bowel and breast cancer – about as well as a specialist cancer risk calculator. For several other cancers, including kidney, laryngeal (throat) and gastro-oesophageal (stomach and gullet) cancer, they performed about the same or better than they do for heart attack and stroke.
Lead author Dr Sam Quill, a HDR UK Big Data for Complex Disease PhD student at the UCL Institute of Cardiovascular Science, said:
“In the UK, we currently offer statins to people at higher risk of heart disease using the QRISK3 tool. Our study suggests the risk of certain cancers could be estimated at the same time. However, the value of these tools in cancer prevention needs to be weighed carefully against wider efforts to reduce cancer risk for everyone. More research is needed to explore which approach and which interventions work best.”
After age and sex, the most influential factors for cancer risk used in the QRISK3 model were smoking status and blood pressure – the latter of which may be linked to other factors that increase cancer risk, including lack of physical activity and excessive alcohol consumption.
The QRISK3 tool is already integrated into GP and hospital computer systems throughout the UK. In England, it is used for the NHS Health Check offered to adults aged 40 to 74 every five years.
Dr Quill added:
“More and more evidence is emerging that many cancers can potentially be prevented. Detecting cancer early through screening is important and is what health systems currently focus on, but there is also more we could do to prevent cancer from developing in the first place.”
This work highlights how expanding the use of existing tools could benefit the NHS’ approach to early detection and cancer prevention. Generating prompts that suggest interventions for reducing cancer risk or inviting high-risk individuals to join relevant cancer screening programmes could save more lives.
Read the paper
