External validation of the systematic coronary risk evaluation 2 (SCORE2) and SCORE2-older persons in cancer patients
Authors' conclusion
SCORE2 underestimated CVD risk in cancer patients.
Study context
- Population
- Cancer patients from the HUNT3 study (2006–08) diagnosed with cancer within 4 years after enrolment, followed until 2023HUNT3 study
- Participants
- 1,622 patients
- Comparison
- SCORE2 vs SCORE2-OP
- Outcome
- Composite of:
- MI
- Stroke
- CVD mortality (10-year fatal and non-fatal CVD risk)
Methodological detailscohort, recalibration by multiplicative adjustment factor based on E/O ratios
- Cohort
- Recalibration by multiplicative adjustment factor based on E/O ratios
Performance
As reported in the abstract
Discrimination (Harrel's C-statistic) and calibration
| Test or model | C-statistic | C-statistic excluding those not surviving first 2 years | E/O ratio, men (before recalibration) | E/O ratio, women (before recalibration) |
|---|---|---|---|---|
| SCORE2 | 0.693 (95% CI 0.643-0.743) | 0.730 (95% CI 0.676-0.784) | 0.91 | 0.63 |
| SCORE2-OP | 0.586 (95% CI 0.529-0.643) | 0.648 (95% CI 0.577-0.720) | Not reported in the abstract | Not reported in the abstract |
C-statistic
SCORE20.693 (95% CI 0.643-0.743)
SCORE2-OP0.586 (95% CI 0.529-0.643)
C-statistic excluding those not surviving first 2 years
SCORE20.730 (95% CI 0.676-0.784)
SCORE2-OP0.648 (95% CI 0.577-0.720)
E/O ratio, men (before recalibration)
SCORE20.91
SCORE2-OPNot reported in the abstract
E/O ratio, women (before recalibration)
SCORE20.63
SCORE2-OPNot reported in the abstract
Further findings
Cardiovascular disease (CVD) events and non-CVD deaths · median follow-up 8.8 years [IQR 1.9-12.6]
- CVD events (39% myocardial infarction (MI), 36% stroke, 25% CVD deaths)
- 252
- Non-CVD deaths
- 708
Original publication
External validation of the systematic coronary risk evaluation 2 (SCORE2) and SCORE2-older persons in cancer patients. Eur J Prev Cardiol. Published 23 June 2025. doi:10.
Summarised from the published abstract; every number is checked against it