Development and validation of a risk predictive nomogram for colon cancer-specific mortality: a competing risk model based on the SEER database

Utilizing the SEER database, we developed a competing risk model along with a nomogram designed for the early identification of colon cancer-specific mortality (CSM) risk.

Clinical and pathological information, along with other significant data, were obtained from the SEER database. Patients were randomly divided into a training set and a validation set. We investigated the independent factors affecting CSM among colon cancer patients using univariate and multivariate analyses within a competing risk framework, ultimately developing a predictive tool for CSM in colon cancer.

Involving 40,261 individuals diagnosed with colon cancer, our study included 10,397 deaths directly due to the disease and an additional 5,828 from other causes. We used a competing risk model to predict cancer-specific mortality (CSM) in these patients. For the training dataset, the model’s area under the curve (AUC) for predicting 1-, 3-, and 5-year cancer-specific survival (CSS) was 0.835 (95% confidence interval [CI] 0.826 to 0.844), 0.849 (95% CI 0.843 to 0.855), and 0.843 (95% CI 0.836 to 0.850), respectively. In the validation group, the AUC values for the same time periods were 0.846 (95% CI 0.833 to 0.860), 0.853 (95% CI 0.843 to 0.862), and 0.846 (95% CI 0.835 to 0.856), respectively. In comparison, traditional survival analysis yielded higher cumulative CSM rates over time than those provided by our competing risk approach.

We created a competitive risk assessment model along with a predictive tool designed to estimate CSM in patients with colon cancer. This nomogram demonstrates high accuracy and reliability, aiding medical professionals in making clinical decisions and developing patient follow-up plans.