New scoring systems for predicting advanced proximal neoplasia in asymptomatic adults with or without knowing distal colorectal findings: a prospective, cross-sectional study
Background
Models estimating risk for advanced proximal colorectal neoplasia (APN) may be used to select colorectal cancer (CRC) screening test, either prior to knowing distal colorectal findings or afterward. Current models have only fair discrimination and nearly all require knowing distal findings.
Objective
Derive and test risk prediction models for APN with and without distal findings.
Setting
Selected endoscopy centers within central Indiana, USA.
Participants
Average-risk persons undergoing first-time screening colonoscopy
Interventions
Demographics, personal and family medical history, lifestyle factors and physical measures were linked to the most advanced finding in proximal and distal colorectal segments. For both models, logistic regression identified factors independently associated with APN on a derivation set. Based on equation coefficients, points were assigned to each factor, and risk for APN was examined for each score. Scores with comparable risks were collapsed into risk categories. Both models and their scoring systems were tested on the validation set.
Main outcome
APN, defined as any adenoma or sessile serrated lesion ≥1 cm, one with villous histology or high-grade dysplasia, or CRC proximal to the descending colon.
Results
Among 3025 subjects in the derivation set (mean age 57.3 ± 6.5 years; 52% women), APN prevalence was 4.5%; 2859 (94.5%) had complete data on risk factors. Independently associated with...
Source: European Journal of Cancer Prevention - Category: Cancer & Oncology Tags: Epidemiology Source Type: research
More News: Cancer | Cancer & Oncology | Colon Cancer | Colonoscopy | Colorectal Cancer | Endoscopy | Epidemiology | Metabolic Syndrome | Smokers | Statistics | Study | Women