Validation of Asia-Pacific Colorectal Screening Score for Asymptomatic Participants and Outpatients in Northwest District of China

Jiang, Wei; Li, Wenyan; Li, Qianqian; Liu, Aiqin; Huang, Wenyu; Hao, Qian; Zhai, Huihong

doi:10.1159/000501073

Cited by 4 publications

(4 citation statements)

References 27 publications

(39 reference statements)

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“…The most important finding of this study is that the APCS score and its modified versions have certain ability to predict CAN in asymptomatic population in Xuzhou. This result is consistent with previous validation of the APCS score in Beijing [ 14 ] and Ningxia [ 15 ], which may mean that risk scoring scores can be used as a preliminary screening for colorectal cancer screening in China. Even more, as the updated Asia Pacific Consensus Recommendations on colorectal cancer screening recommended [ 11 ], the risk scoring system can select high-risk patients for colonoscopy and reduce the colonoscopy resource load required to detect one CAN.…”

Section: Discussionsupporting

confidence: 91%

Validation of the Asia-Pacific colorectal screening score and its modified versions in predicting colorectal advanced neoplasia in Chinese population

et al. 2022

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Background Colorectal cancer is one of the most common cancers in the world. Several studies suggest using the Asia-Pacific colorectal screening (APCS) score and its modified versions to select high-risk populations for early colonoscopy, but external validation remains rare, and which score should be selected for CRC screening in China is unclear. Validation of multiple scores in the same population might help to choose the best performing score. Methods We conducted a cross-sectional study under the framework of Cancer Screening Program in Urban China, data from asymptomatic colorectal cancer screening in Xuzhou was used to validate the APCS score, the colorectal neoplasia predict (CNP) score, the Korean colorectal screening (KCS) score, the Modified APCS score and the 8-point risk score in predicting colorectal advanced neoplasia (CAN). Results 1804 subjects were included in the analysis and 112 CAN (6.21%) was detected. In each score, the detection rate of CAN was higher in the high-risk group than in the non-high-risk group (P < 0.05), and the RR (95%C.I.) ranged 2.20 (1.50–3.22) [8-point risk] to 4.00 (2.41–6.65) [Modified APCS]. The c-statistics (95%C.I.) of the scoring systems ranged from 0.58 (0.53–0.62) [8-point risk] to 0.65 (0.61–0.69) [KCS]. The sensitivity (95%C.I.) of these systems ranged from 31.25 (22.83–40.70) [8-point risk] to 84.82 (76.81–90.90) [Modified APCS], while the specificity (95%C.I.) ranged from 43.50 (41.12–45.90) [Modified APCS] to 83.81 (81.96–85.53) [8-point risk]. Using the APCS scoring system as a comparator, the net reclassification improvement (NRI) of each modified version ranged from − 10.34% (95%C.I.: − 22.63 to 1.95%) [8-point risk] to 4.79% (95%C.I.: − 1.50% to 11.08) [KCS]. The colonoscopy resource load (95%C.I.) ranged from 9 [1–3] [8-point risk] to 11 [3–5] [APCS and Modified APCS]. Conclusions The APCS score and its modified versions have certain ability to predict the risk of advanced neoplasia and reduce the resource load. The modified APCS score and the KCS score seemed the preferable systems to classify high risk subjects based on its high RR, sensitivity and predictive ability in the selected population. Future research could focus on adding risk factors or combining with laboratory test results to improve the predictive power of the scoring system.

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Section: Discussionsupporting

confidence: 91%

Validation of the Asia-Pacific colorectal screening score and its modified versions in predicting colorectal advanced neoplasia in Chinese population

et al. 2022

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“…An updated search confirmed an additional three eligible studies, resulting in a final sample of 13 studies included in the meta-analysis. [9][10][11][12][13][17][18][19][20][21][22][23][24][25][26][27] Study characteristics and quality assessment. Tables 1 and 2 summarize the characteristics and quality evaluation of the 13 included studies, all of which were conducted in the Asia-Pacific region.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 10 eligible studies were identified in this initial search. An updated search confirmed an additional three eligible studies, resulting in a final sample of 13 studies included in the meta‐analysis 9–13,17–27 …”

Section: Resultsmentioning

confidence: 99%

Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review

Luu,

Trinh,

Tran

et al. 2024

J of Gastro and Hepatol

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Background and AimThis study systematically reviewed and meta‐analyzed the performance of the Asia–Pacific Colorectal Screening (APCS) score and its incorporation with the fecal immunochemical test (FIT) in stratifying the risk of advanced colorectal neoplasia (ACN).MethodsWe systematically searched for relevant articles in 12 electronic databases and registers on October 20, 2021, and updated the search to September 1, 2023. Random‐effect models were used to obtain the pooled performance statistics of the APCS score for ACN risk.ResultsFrom the 101 records screened, 13 eligible studies in the Asia–Pacific region involving 69 762 subjects who had undergone colonoscopy were enrolled. The pooled prevalences of ACN in the average‐risk (AR) tier (APCS 0–1), moderate‐risk (MR) tier (APCS 2–3), and high‐risk (HR) tier (APCS ≥ 4) groups were 0.9%, 3.1%, and 8.1%, respectively. Compared with the combined AR–MR group, the HR group was significantly associated with a higher ACN risk (pooled diagnostic odds ratio: 2.84, 95% confidence interval [CI]: 2.35–3.45, P < 0.001). The APCS score showed a sensitivity of 0.42 (95% CI: 0.40–0.44) and a specificity of 0.86 (95% CI: 0.85–0.86) for predicting the ACN risk, with a weighted area under the curve of 0.642 (95% CI: 0.610–0.657). The combination of the APCS score and FIT substantially improved ACN risk identification, demonstrating pooled diagnostic odds ratios of 4.02 (95% CI: 2.50–6.49) in the AR–MR groups and 5.44 (95% CI: 1.89–15.63) in the MR–HR groups.ConclusionsThe APCS score could effectively stratify the ACN risk in the Asia–Pacific population. Incorporating FIT further improves its performance in identifying high‐risk subjects who should be prioritized for colonoscopy screenings.

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“…10 Currently, the CRN screening scoring system is mainly used to evaluate asymptomatic individuals, and there are few studies on symptomatic patients. 43,44 In the current study we aimed to develop a CRN risk score for patients with non-specific GI symptoms to optimize the allocation of colonoscopic resources. Compared to ACN, CRN has a higher detection rate during the colonoscopic procedure.…”

Section: Discussionmentioning

confidence: 99%

Establishment and validation of symptomatic patients colorectal screening score for predicting colorectal neoplasia risk

Wang,

Zhang,

Liu

et al. 2023

J of Digest Diseases

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BackgroundCurrently, most colorectal neoplasia (CRN) screening strategies target asymptomatic patients. It is unclear whether patients with non‐specific gastrointestinal symptoms should undergo risk stratification for CRN.AimsTo develop a CRN risk score specifically for patients with non‐specific gastrointestinal symptoms.MethodsWe prospectively collected data from patients who underwent initial colonoscopy between June 2020 and June 2021. A new risk score was constructed and its applicability was evaluated.ResultsA total of 1,522 consecutive patients were enrolled, among whom 1016 symptomatic patients were randomly divided into training cohort and validation cohort at a ratio of 7:3. The Symptomatic Patients Colorectal Screening (SPCS) score we constructed demonstrated higher diagnostic efficacy and sensitivity than several scoring systems reported previously. We divided the SPCS score into low‐risk group (‐2~3 points) and high‐risk group (4~10 points). The detection rates of CRN in the training and validation cohorts of the high‐risk group were 41.7% and 37.0%. The SPCS score detected 79.3% of CRN (188/237) and 87.5% of advanced CRN (42/48) in high‐risk group, which reduced the workload of colonoscopy to only 45.9% (466/1016).ConclusionsOur study has established and validated an effective CRN risk score for symptomatic patients, which accurately classifies individuals into low‐risk and high‐risk groups and optimizes colonoscopy resource allocation.This article is protected by copyright. All rights reserved.

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Validation of Asia-Pacific Colorectal Screening Score for Asymptomatic Participants and Outpatients in Northwest District of China

Cited by 4 publications

References 27 publications

Validation of the Asia-Pacific colorectal screening score and its modified versions in predicting colorectal advanced neoplasia in Chinese population

Validation of the Asia-Pacific colorectal screening score and its modified versions in predicting colorectal advanced neoplasia in Chinese population

Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review

Establishment and validation of symptomatic patients colorectal screening score for predicting colorectal neoplasia risk

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