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ORIGINAL RESEARCH article

Front. Oncol.
Sec. Cancer Epidemiology and Prevention
Volume 14 - 2024 | doi: 10.3389/fonc.2024.1457446
This article is part of the Research Topic Obesity, Diabetes, and Their Impact on Cancer View all articles

Predicting the risk of colorectal cancer among diabetes patients using a random survival forest-guided approach

Provisionally accepted
Sarah Tsz Yui Yau Sarah Tsz Yui Yau Chi Tim Hung Chi Tim Hung Eman Yee Man Leung Eman Yee Man Leung *Ka Chun Chong Ka Chun Chong Albert Lee Albert Lee Eng Kiong Yeoh Eng Kiong Yeoh
  • The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China

The final, formatted version of the article will be published soon.

    ABSTRACT Background Colorectal cancer (CRC) is the third most frequently diagnosed cancer worldwide. Diabetes and CRC share many overlapping lifestyle risk factors such as obesity, heavy alcohol use, and diet. This study aims to develop a risk scoring system for CRC prediction among diabetes patients using routine medical records. Methods A retrospective cohort study was conducted using electronic health records of Hong Kong. Patients who received diabetes care in public general outpatient clinics between 2010 and 2019 and had no cancer history were identified, and followed up until December 2019. The outcome was diagnosis of CRC during follow-up. For model building, predictors were first selected using random survival forest, and weights were subsequently assigned to selected predictors using Cox regression. Results Of the 386,325 patients identified, 4,199 patients developed CRC during a median follow-up of 6.2 years. The overall incidence rate of CRC was 1.93 per 1000 person-years. In the final scoring system, age, waist-to-hip ratio, and serum creatinine were included as predictors. The C-index on test set was 0.651 (95%CI: 0.631-0.669). Elevated serum creatinine (≥127 µmol/L) could be a potential important predictor of increased CRC risk. Conclusion While obesity is a well-known risk factor for CRC, renal dysfunction could be potentially linked to an elevated risk of CRC among diabetes patients. Further studies are warranted to explore whether renal function could be a potential parameter to guide screening recommendation for diabetes patients.

    Keywords: colorectal cancer, diabetes, risk prediction, survival analysis, random forest

    Received: 30 Jun 2024; Accepted: 13 Sep 2024.

    Copyright: © 2024 Yau, Hung, Leung, Chong, Lee and Yeoh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Eman Yee Man Leung, The Jockey Club School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, China

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