The Asia-Pacific Colorectal Screening score: a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects

Yeoh, Khay Guan; Ho, Khek Yu; Chiu, Han–Mo; Zhu, Feng; Ching, Jessica Y. L.; Wu, Deng Chyang; Matsuda, Takahisa; Byeon, Jeong Sik; Lee, Sang Kil; Goh, Khean Lee; Sollano, José D.; Rerknimitr, Rungsun; Leong, Rupert W.; Tsoi, Kelvin K.; Lin, Jaw Town; Sung, Joseph J.Y.

doi:10.1136/gut.2010.221168

Cited by 246 publications

(323 citation statements)

References 37 publications

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“…Third, the SP risk score proposed in our study was developed in a reallife cohort, including symptomatic and asymptomatic patients, and hence generalizability to a screening population needs to be further examined. Fourth, the ability of identifying patients with 1 LPD SP, using the clinical SP risk score proposed in our study is only moderate with a sensitivity of 33% and specificity of 94%, albeit comparable with other clinical scores (49,50). Finally, not unexpected, prevalences of 1 LPD SP and SSA/Ps without dysplasia were higher in the validation cohort than the derivation cohort.…”

Section: Discussionmentioning

confidence: 90%

Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice

Bouwens

Winkens

Rondagh

et al. 2013

Cancer Prevention Research

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Large, proximal, or dysplastic (LPD) serrated polyps (SP) need accurate endoscopic recognition and removal as these might progress to colorectal cancer. Herewith, we examined the risk factors for having 1 LPD SP. We developed and validated a simple SP risk score as a potential tool for improving their detection. We reviewed clinical, endoscopic, and histologic features of serrated polyps in a study of patients undergoing elective colonoscopy (derivation cohort). A self-administered questionnaire was obtained. We conducted logistic regression analyses to identify independent risk factors for having 1 LPD SP and incorporated significant variables into a clinical score. We subsequently tested the performance of the SP score in a validation cohort. We examined 2,244 patients in the derivation and 2,402 patients in the validation cohort; 6.3% and 8.2% had 1 LPD SP, respectively. Independent risk factors for LPD SPs were age of more than 50 years [OR 2.2; 95% confidence interval (CI), 1.3-3.8; P ¼ 0.004], personal history of serrated polyps (OR 2.6; 95% CI, 1.3-4.9; P ¼ 0.005), current smoking (OR 2.2; 95% CI, 1.4-3.6; P ¼ 0.001), and nondaily/no aspirin use (OR 1.8; 95% CI, 1.1-3.0; P ¼ 0.016). In the validation cohort, a SP score 5 points was associated with a 3.0-fold increased odds for LPD SPs, compared with patients with a score <5 points. In the present study, age of more than 50 years, a personal history of serrated polyps, current smoking, and nondaily/no aspirin use were independent risk factors for having LPD SPs. The SP score might aid the endoscopist in the detection of such lesions. Cancer Prev Res; 6(8); 855-63. Ó2013 AACR.

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Section: Discussionmentioning

confidence: 90%

Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice

Bouwens

Winkens

Rondagh

et al. 2013

Cancer Prevention Research

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“…Many other countries, such as Australia [19], Poland [24], Hong Kong [28], Italy [29], Qatar [41], Saudi Arabia [43], Spain [52] and Sri Lanka [15] have also developed country-specific risk prediction models for colorectal cancer. When considering the global approach two models have been developed globally [27,30] while another has been developed for Asia [37].…”

Section: Questionnairementioning

confidence: 99%

“…A majority (n=35) of models include variables obtained through a questionnaire [18,19,21,22,23,24,25,26,27,28,30,33,36,37,38,39,40,41,42,43,44,45,46,49,50,51,53,54]. The questionnaires range from those with only one or two simple questions to those with detailed questions on factors such as diet, physical activity, alcohol and smoking habits and past medical facts.…”

Section: Development Of the Modelsmentioning

confidence: 99%

Risk prediction models for colorectal cancer: A Scoping review

Samarakoon¹,

Pathmeswaran

Gunawardena³

2018

J. Postgrad. Inst. Med.

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Background and objectives Many risk prediction models have been developed globally to identify specific populations at high risk for colorectal cancer in specific settings. Documentation of available evidence from existing studies will serve as a useful information base. We performed a scoping review, to review and analyse published risk prediction models for colorectal cancer the world over. Methods A scoping review was undertaken to address the following question 'what are the existing risk prediction models to identify the risk of developing colorectal cancer among individuals in different countries and settings?' using the framework developed by Arksey and O'Malley for scoping reviews. Forty-one articles were included in this review from database searches and from additional searches. The titles and abstracts were reviewed using predetermined screening criteria. We limited our search to existing literature in English language and included both observational and interventional studies. Results Out of the 58 risk prediction models identified, most were developed for colorectal cancer followed by advanced colorectal cancer. Most of the articles reviewed were cross sectional studies or cohort studies. Statistical methods such as multiple logistic regression was used by a majority, while few have incorporated non-statistical methods such as consensus method and extracting data from published literature. The authors of the 58 risk prediction models have considered 77 different risk factors excluding the genetic variants. Conclusions This comprehensive scoping review demonstrates the capacity of the existing risk models to stratify the general population into risk categories, detailing the studies conducted, location, study design, outcome, overview of the methods, data source and the identified risk predictors. While striving to build on existing knowledge, the review also identifies the research gaps and the need for further improvement.

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“…Asia-Pacific guidelines also recommend earlier screening in FDRs of CRC patients, that is, before 50 years of age [38] . A scoring system, based on several risk factors, such as age, sex, family history and smoking habit, has been developed by the Asia-Pacific Working Group for stratifying risk and prioritizing highrisk individuals for earlier screening [39] . According to this scoring system, validated in a 15-country multicenter Asian study on asymptomatic subjects, moderate-to-high-risk individuals should undergo colonoscopy, while those classified as average risk should undergo a fecal immunochemical test (FIT) followed by colonoscopy in case of a positive result [38] .…”

Section: Familial Crc Screening: When To Domentioning

confidence: 99%

Familial colorectal cancer screening: When and what to do?

Blanco¹,

Paoluzi²,

Sileri³

et al. 2015

WJG

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Colorectal cancer (CRC) is the third leading cause of death worldwide and represents a clinical challenge. Family members of patients affected by CRC have an increased risk of CRC development. In these individuals, screening is strongly recommended and should be started earlier than in the population with average risk, in order to detect neoplastic precursors, such as adenoma, advanced adenoma, and nonpolypoid adenomatous lesions of the colon. Fecal occult blood test (FOBT) is a non invasive, widespread screening method that can reduce CRC-related mortality. Sigmoidoscopy, alone or in addition to FOBT, represents another screening strategy that reduces CRC mortality. Colonoscopy is the best choice for screening highrisk populations, as it allows simultaneous detection and removal of preneoplastic lesions. The choice of test depends on local health policy and varies among countries. Core tip: One-fifth of people who develop colorectal cancer (CRC) have a first-degree relative (FDR) affected by this malignancy. Screening is an efficient method to reduce mortality for CRC and should be started in FDRs earlier than in the population at average risk. There is a large disparity in guidelines for screening in familial CRC, therefore, here we address the principal indication and methods for screening in this population at increased risk. Recent or emerging methods to improve the participation rate in screening programs are described. Ongoing trials on CRC screening are also reported.

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The Asia-Pacific Colorectal Screening score: a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects

Abstract: The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.

Cited by 246 publications

References 37 publications

Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice

Simple Clinical Risk Score Identifies Patients with Serrated Polyps in Routine Practice

Risk prediction models for colorectal cancer: A Scoping review

Familial colorectal cancer screening: When and what to do?

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