Original articleAlimentary tractDevelopment and Validation of a Scoring System to Identify Individuals at High Risk for Advanced Colorectal Neoplasms Who Should Undergo Colonoscopy Screening
Section snippets
Study Design and Study Population
Our study was performed among participants of the German screening colonoscopy program by linking self-reported information on CRC risk factors with findings at colonoscopy. Detailed information on the German screening colonoscopy program has been provided elsewhere.15 Briefly, colonoscopy was offered as a primary screening examination free of charge to the whole residents aged 55 years and older in Germany since 2002. Screening colonoscopy is conducted almost exclusively in practices of
Results
Overall, 7891 and 3519 participants of the screening colonoscopy were included in the derivation and validation samples, respectively. The most advanced finding at colonoscopy in the 2 samples was CRC in 107 (1.4%) and 29 (0.8%), advanced adenoma in 780 (9.9%) and 354 (10.1%), and other (nonadvanced) adenoma in 1815 (21.4%) and 750 (20.1%) participants, respectively. The prevalence of any advanced neoplasm was 11.2% and 10.9% in the derivation and validation samples, respectively.
The main
Discussion
In this analysis, we derived a scoring system to identify individuals at high risk for at least one advanced colorectal neoplasm from a large screening population based on some easy-to-collect information and validated it in an independent sample. Participants were classified into 5 risk categories (very low, low, intermediate, high, and very high) according to quintiles of the risk score. The risk of presence of at least one advanced neoplasm was about 4-fold higher in the top quintile than in
References (30)
- et al.
Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial
Lancet
(2010) - et al.
Implementation and outcomes of a multidisciplinary high-risk breast cancer program: the William Beaumont Hospital experience
Clin Breast Cancer
(2012) - et al.
Development of a risk score for colorectal cancer in men
Am J Med
(2007) - et al.
Efficacy of a nationwide screening colonoscopy program for colorectal cancer
Gastroenterology
(2012) - et al.
Low risk of colorectal cancer and advanced adenomas more than 10 years after negative colonoscopy
Gastroenterology
(2010) - et al.
Male sex and smoking have a larger impact on the prevalence of colorectal neoplasia than family history of colorectal cancer
Clin Gastroenterol Hepatol
(2010) - et al.
10-Year risk of colorectal cancer: development and validation of a prediction model in middle-aged Japanese men
Cancer Epidemiol
(2010) - et al.
Validation of the Harvard Cancer Risk Index: a prediction tool for individual cancer risk
J Clin Epidemiol
(2004) - et al.
Use of colonoscopy as a primary screening test for colorectal cancer in average risk people
Am J Gastroenterol
(2003) - et al.
Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008
Int J Cancer
(2010)
Cochrane systematic review of colorectal cancer screening using the fecal occult blood test (hemoccult): an update
Am J Gastroenterol
Effect of flexible sigmoidoscopy-based screening on incidence and mortality of colorectal cancer: a systematic review and meta-analysis of randomized controlled trials
PLoS Med
Long-term efficacy of sigmoidoscopy in the reduction of colorectal cancer incidence
J Natl Cancer Inst
Protection from colorectal cancer after colonoscopy: a population-based, case-control study
Ann Intern Med
Colonoscopic polypectomy and long-term prevention of colorectal-cancer deaths
N Engl J Med
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2021, Preventive MedicineCitation Excerpt :Taken together, this model is highly specific with a high NPV, indicating that it could be clinically useful in supporting clinicians when deciding whether a patient should not be recommended to undergo a screening colonoscopy. There are several published risk prediction models derived on similar populations for advanced adenomas proposed for use in considering who should undergo screening colonoscopy (Wong et al., 2014; Kaminski et al., 2014; Tao et al., 2014; Shaukat et al., 2015). Most recently, in 2015, Shaukat and colleagues developed an internally valid clinical score for the prediction of adenomas at screening colonoscopy yielding an AUC of 0.64 (Shaukat et al., 2015)..
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Conflicts of interest The author discloses no conflicts.
Funding This study was supported in part by grants from the Central Research Institute of Ambulatory Health Care in Germany, Berlin, Germany. The sponsor had no role in the study design; in the collection, analysis, and interpretation of data; preparation; review; or approval of the manuscript.