Development of a risk score for colorectal cancer in Chinese males: A prospective cohort study

Guo, Lanwei; Chen, Hongda; Wang, Gang; Lyu, Zhangyan; Feng, Xiaoshuang; Wei, Luopei; Li, Xin; Wen, Yan; Lu, Ming; Chen, Yuheng; Shi, Jufang; Ren, Jiansong; Lin, Chunqing; Yu, Xinyang; Chen, Shuohua; Wu, Shouling; Li, Ni; Dai, Min; He, Jie

doi:10.1002/cam4.2734

Cited by 6 publications

(10 citation statements)

References 30 publications

(32 reference statements)

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“…Colorectal cancer (CRC) is one of the most commonly diagnosed cancers worldwide, with an age-standardized incidence rate of 19.4 per 100,000 and an age-standardized mortality rate of 8.9 per 100,000, in 2018 (1). In recent years, the incidence of CRC is increasing in China owing to the improvement of living standards, lifestyle changes, and the growing number of elderly population (2). In China, the world standardized incidence and mortality of CRC were 19.4 and 9.0 per 100,000, respectively.…”

Section: Introductionmentioning

confidence: 99%

Determinants of Participation and Detection Rate of Colorectal Cancer From a Population-Based Screening Program in China

Zhang

Zheng

et al. 2020

Front. Oncol.

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Colorectal cancer (CRC) screening has been widely implemented in Europe and the USA. However, there is little evidence of participation and diagnostic yields in population-based CRC screening in China. The participation rate and detection of colorectal lesions in this program were reported and related factors were explored. The analysis was conducted in the context of the Cancer Screening Program in Urban China, which recruited 282,377 eligible participants aged 40-74 years from eight cities in Henan province from 2013 to 2019. A total of 39,834 participants were evaluated to be high risk for CRC by an established risk score system and were subsequently recommended for colonoscopy. Of 39,834 with high risk for CRC, 7,454 subjects undertook colonoscopy (participation rate of 18.71%). We found that 50-64 years, high level of education, marriage, former smoking, current alcohol drinking, low levels dietary intake of vegetables, high levels dietary intake of processed meat, lack of physical activity, fecal occult blood test positive result, history of colonic polyp, history of colorectitis, and family history of CRC were associated with increased participation of colonoscopy screening. Overall, 17 CRC (0.23%), 95 advanced adenoma (1.27%), 478 non-advanced adenomas dysplasia (6.41%), 248 hyperplastic polyp (3.33%), and 910 other benign lesions (12.21%) were detected. The findings from the study will provide important references for designing effective population-based CRC screening strategies in the future. Given the relatively low participation rate, there was room for improvement in the yield of CRC screening.

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Section: Introductionmentioning

confidence: 99%

Determinants of Participation and Detection Rate of Colorectal Cancer From a Population-Based Screening Program in China

Zhang

Zheng

et al. 2020

Front. Oncol.

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“…All articles published either a point score, Cox proportional hazards model, or a logistic regression, other than the Ma article, which had both a point score and Cox model. Four models (Driver [ 25 ], Ma Point [ 12 ], Ma Cox [ 12 ], and Guo [ 28 ]) were developed only in a male population; the rest were developed in both male and female populations. Two models (Guo [ 28 ] and Chen [ 29 ]) were developed in Chinese populations.…”

Section: Resultsmentioning

confidence: 99%

“…Four models (Driver [ 25 ], Ma Point [ 12 ], Ma Cox [ 12 ], and Guo [ 28 ]) were developed only in a male population; the rest were developed in both male and female populations. Two models (Guo [ 28 ] and Chen [ 29 ]) were developed in Chinese populations. Five models were developed using < 500 cases of CRC, the two Ma [ 12 ] models used 543 cases, the Hong [ 27 ] model was developed from 1117 cases, and Aleksandrova [ 30 ] from 3645 cases of CRC.…”

Section: Resultsmentioning

confidence: 99%

External validation of models for predicting risk of colorectal cancer using the China Kadoorie Biobank

Abhari

Thomson

Yang

et al. 2022

BMC Med

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Background In China, colorectal cancer (CRC) incidence and mortality have been steadily increasing over the last decades. Risk models to predict incident CRC have been developed in various populations, but they have not been systematically externally validated in a Chinese population. This study aimed to assess the performance of risk scores in predicting CRC using the China Kadoorie Biobank (CKB), one of the largest and geographically diverse prospective cohort studies in China. Methods Nine models were externally validated in 512,415 participants in CKB and included 2976 cases of CRC. Model discrimination was assessed, overall and by sex, age, site, and geographic location, using the area under the receiver operating characteristic curve (AUC). Model discrimination of these nine models was compared to a model using age alone. Calibration was assessed for five models, and they were re-calibrated in CKB. Results The three models with the highest discrimination (Ma (Cox model) AUC 0.70 [95% CI 0.69–0.71]; Aleksandrova 0.70 [0.69–0.71]; Hong 0.69 [0.67–0.71]) included the variables age, smoking, and alcohol. These models performed significantly better than using a model based on age alone (AUC of 0.65 [95% CI 0.64–0.66]). Model discrimination was generally higher in younger participants, males, urban environments, and for colon cancer. The two models (Guo and Chen) developed in Chinese populations did not perform better than the others. Among the 10% of participants with the highest risk, the three best performing models identified 24–26% of participants that went on to develop CRC. Conclusions Several risk models based on easily obtainable demographic and modifiable lifestyle factor have good discrimination in a Chinese population. The three best performing models have a higher discrimination than using a model based on age alone.

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“…The potential use of risk stratification models based on established risk factors in CRC screening has been proposed ( 13 , 14 ). In a previous study, the most common risk factors were age, sex, family history in first-degree relatives, body mass index, smoking, and the models generally yielded modest discriminative efficacy with the area under the receiver operating characteristics curves (ROC) ranging from 0.61 to 0.70 ( 13 ).…”

Section: Introductionmentioning

confidence: 99%

Comparative yield and efficiency of strategies based on risk assessment and fecal immunochemical test in colorectal cancer screening: A cross-sectional population-based analysis

Chen

Wang

et al. 2021

Chinese Journal of Cancer Research

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Objective Integration of risk stratification into fecal immunochemical test (FIT) might aid in the suboptimal detection of advanced neoplasms by FIT in colorectal cancer (CRC) screening. A comparative study was conducted to evaluate the participation and diagnostic yield of the parallel combination of questionnaire-based risk assessment (QRA) and FIT, FIT-only and QRA-only strategies in a CRC screening program in China. Methods The study included 29,626 individuals aged 40−74 years and invited to participate in a CRC screening program in China. Participants were first invited to undertake QRA and one-time FIT (OC-sensor). Participants with positive QRA or FIT were deemed to be high-risk individuals who were recommended for subsequent colonoscopy. Participation, detection rate, and resource demand for colonoscopy were calculated and compared. Results Of the 29,626 invitees, 20,203 completed the parallel combination, 8,592 completed the QRA-only, and 11 completed the FIT-only strategy. For the parallel combination, FIT-only, and QRA-only strategies, the overall positivity rates were 10.2% (2,928/28,806), 5.4% (1,096/20,214), and 6.8% (1,944/28,795), respectively; the yield of advanced neoplasm per 10,000 invitees were 46.9 [95% confidence interval (95% CI): 39.8−55.4], 36.8 (95% CI: 30.5−44.4), and 12.2 (95% CI: 8.8−16.8), respectively; the positive predictive values for detecting advanced neoplasms among participants who completed colonoscopy were 4.7% (95% CI: 4.0%−5.6%), 9.9% (95% CI: 8.3%−11.9%), and 1.9% (95% CI: 1.3%−2.6%), respectively; the number of colonoscopies required to detect one advanced neoplasm was 11.4 (95% CI: 9.8−13.4), 5.7 (95% CI: 4.8−6.7), and 28.4 (95% CI: 20.7−39.2), respectively. Conclusions The parallel combination of QRA and FIT did not show superior efficacy for detecting advanced neoplasm compared with FIT alone in this CRC screening program.

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Development of a risk score for colorectal cancer in Chinese males: A prospective cohort study

Cited by 6 publications

References 30 publications

Determinants of Participation and Detection Rate of Colorectal Cancer From a Population-Based Screening Program in China

Determinants of Participation and Detection Rate of Colorectal Cancer From a Population-Based Screening Program in China

External validation of models for predicting risk of colorectal cancer using the China Kadoorie Biobank

Comparative yield and efficiency of strategies based on risk assessment and fecal immunochemical test in colorectal cancer screening: A cross-sectional population-based analysis

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