Introduction
tumor, glioblastoma multiforme, Prostate Lung Colorectal Ovarian, breast cancers, cancer stage, cancer, tumors, Cancer
COLORECTAL CANCER, GLIOBLASTOMA MULTIFORME, RECURRENCE, TUMOR, DISEASE COURSE, BREAST CANCER, CANCER, DISEASE, SOLID TUMORS, TUMORS, CANCER
Prognostic models are important for informing patients, caregivers, and clinicians about the likely disease course. Prognostic models often use patient demographic information (e.g., age, sex), clinical variables (e.g., cancer stage, histology), genetic information, and imaging features at the time of disease diagnosis. These models have been developed for many cancer types including glioblastoma multiforme (GBM)Many solid tumors are detected via screening such as colonoscopies for colorectal cancer, mammograms for breast cancer, and Pap tests (Pap smears) for cervical cancerPast studies have found that detection method can have prognostic significance on patient survival and disease recurrence. In a study of Finnish Cancer Registry patients diagnosed between 1991 and 1992, mammographically (screen) detected breast cancers were shown to have less chance of distant recurrence relative to tumors detected outside of screening, after controlling for cancer biological factors at diagnosisThe reason why detection method has prognostic significance is not completely known and potentially consists of lead-time and length biases inherent in screening programs, as well as true survival benefit achieved due to effective treatment following an early diagnosis of cancer. Detection method may be a proxy for intra-stage shift (among tumors of a given stage, screen-detected tumors may be earlier in their development, on average, than symptom-detected tumors). Moreover, detection method may be a proxy for growth rate of tumor, a variable of obvious prognostic value that is not easily measured, and hence is rarely used in prognostic models. Slower growing or even indolent tumors have better prognosis regardless of detection method (length bias). In this study, we assess the prognostic significance of cancer detection method in the lung component of the Prostate Lung Colorectal Ovarian (PLCO) trialSummary of the lung component of the PLCO trial.