Abstract
Background/Aims Cancer prognosis is one of the leading topics of interest for cancer patients, their caregivers and providers. Literature suggests that nomograms that use prognostic algorithms integrating several predictors improve prognostic accuracy. There has been increasing interest in the availability and use of web-based tools by both health care providers and patients for obtaining information about health promotion and disease management. Our study aimed to review the available online cancer prognostic tools, to provide input on the implications for their use in clinical settings, and to create a centralized repository for providers to access.
Methods Using a systematic approach, we searched the Internet, Medline, and consulted with experts to identify existing online prognostic tools. To be eligible, tools had to have an English version, focus on cancer, have an interactive component, and provide at least one of the following output measures: cancer or non-cancer specific mortality/overall survival; disease free survival (DFS)/recurrence; clinical response to treatment; progression free survival (PFS)/spread; cancer therapy induced side effects. Each tool was reviewed for content and format.
Results Twenty-two prognostic tools addressing 89 different cancers (min: 1, max: 84) were identified. We classified unique cancer sites under 13 main categories. Tools focused on prostate (n = 11), colorectal (n = 10), breast (n = 8), and melanoma (n = 6), though at least one tool was identified for most malignancies. The input variables for the tools included cancer characteristics (n = 22), with fewer having inputs for patient characteristics (n = 18) or comorbidities (n = 9). Effect of therapy on prognosis was included in 19 tools. The most common predicted outcome was cancer specific survival/mortality (n = 17) followed by disease free survival (DFS)/recurrence (n = 14). While all of the tools were available online, only four suggested usability by patients.
Conclusions The process of identifying available tools was time consuming as there was no one location where all existing cancer prognostic tools were easily accessible and compared. Using a systematic review, we identified and compiled a comprehensive repository of 22 currently existing online prognostic tools. A website was created for these tools: www.cancercalculators.org. Cancer prognostic tools hold great promise in facilitating patient-centered communication and decision-making and helping patients prepare for life post treatment.
