Development and external validation of a head and neck cancer risk prediction model

Craig Smith*, Tom Dudding, Mark Gormley, Alex D McMahon, Donald M. Lyall, Mariel Goulart, et al

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review


Background: Head and Neck Cancer (HNC) incidence is on the rise, often diagnosed at late stage and associated with poor prognoses. Risk prediction tools have a potential role in prevention and early detection.

Methods: The IARC-ARCAGE European case-control study was used as the model development dataset. A clinical HNC risk prediction model using behavioural and demographic predictors was developed via multivariable logistic regression analyses. The model was then externally validated in the UK Biobank cohort. Model performance was tested using discrimination and calibration metrics.

Results: 1926 HNC cases and 2043 controls were used for the development of the model. The development dataset model including sociodemographic, smoking and alcohol variables had moderate discrimination, with an Area Under Curve (AUC) value of 0.75 (95% CI, 0.74 -0.77); the calibration slope (0.75) and tests were suggestive of good calibration. 384,616 UK Biobank participants (with 1177 HNC cases) were available for external validation of the model. Upon external validation, the model had an AUC of 0.62 (95% CI, 0.61 - 0.64).

Conclusions: We developed and externally validated a HNC risk prediction model using the ARCAGE and UK Biobank studies, respectively. This model had moderate performance in the development population and acceptable performance in the validation dataset. Demographics and risk behaviours are strong predictors of HNC, and this model may be a helpful tool in primary dental care settings to promote prevention and determine recall intervals for dental examination. Future addition of HPV serology or genetic factors could further enhance individual risk prediction.
Original languageEnglish
JournalHead and Neck
Early online date8 Jun 2024
Publication statusE-pub ahead of print - 8 Jun 2024

Bibliographical note

Publisher Copyright:
© 2024 The Author(s). Head & Neck published by Wiley Periodicals LLC.


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