TY - JOUR
T1 - The Asia-Pacific Colorectal Screening score
T2 - A validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects
AU - Yeoh, Khay Guan
AU - Ho, Khek Yu
AU - Chiu, Han Mo
AU - Zhu, Feng
AU - Ching, Jessica Y.L.
AU - Wu, Deng Chyang
AU - Matsuda, Takahisa
AU - Byeon, Jeong Sik
AU - Lee, Sang Kil
AU - Goh, Khean Lee
AU - Sollano, Jose
AU - Rerknimitr, Rungsun
AU - Leong, Rupert
AU - Tsoi, Kelvin
AU - Lin, Jaw Town
AU - Sung, Joseph J.Y.
PY - 2011/9
Y1 - 2011/9
N2 - Objective: To develop and validate a clinical risk score predictive of risk for colorectal advanced neoplasia for Asia. Methods: A prospective, cross-sectional and multicentre study was carried out in tertiary hospitals in 11 Asian cities. The subjects comprise 2752 asymptomatic patients undergoing screening colonoscopy. From a development set of 860 asymptomatic subjects undergoing screening colonoscopy, multiple logistic regression was applied to identify significant risk factors for advanced colorectal neoplasia defined as invasive carcinoma or advanced adenoma. The ORs for significant risk factors were utilised to develop a risk score ranging from 0 to 7 (Asia-Pacific Colorectal Screening (APCS) score). Three tiers of risk were arbitrarily defined: 0-1 'average risk' (AR); 2-3 'moderate risk' (MR); and 4-7 'high risk' (HR). Subjects undergoing screening colonoscopy between July 2006 and December 2007 were prospectively enrolled to form an independent validation group. Each subject had a personal APCS score calculated by summing the points attributed from the presence of risk factors in the individuals. The performance of the APCS score in predicting risk of advanced neoplasia was evaluated. Results: There were 860 subjects in the derivation set and 1892 subjects in the validation set, with a baseline prevalence of advanced neoplasia of 4.5% and 3%, respectively. Applying the APCS stratification in the validation set, 559 subjects (29.5%) were in the AR tier, 966 subjects (51.1%) in the MR tier and 367 (19.4%) subjects in the HR tier. The prevalence of advanced neoplasia in the AR, MR and HR groups was 1.3, 3.2 and 5.2%, respectively. The subjects in the MR and HR tiers had 2.6-fold (95% CI 1.1 to 6.0) and 4.3-fold (95% CI 1.8 to 10.3) increased prevalence of advanced neoplasia, respectively, than those in the AR tier. Conclusions: The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.
AB - Objective: To develop and validate a clinical risk score predictive of risk for colorectal advanced neoplasia for Asia. Methods: A prospective, cross-sectional and multicentre study was carried out in tertiary hospitals in 11 Asian cities. The subjects comprise 2752 asymptomatic patients undergoing screening colonoscopy. From a development set of 860 asymptomatic subjects undergoing screening colonoscopy, multiple logistic regression was applied to identify significant risk factors for advanced colorectal neoplasia defined as invasive carcinoma or advanced adenoma. The ORs for significant risk factors were utilised to develop a risk score ranging from 0 to 7 (Asia-Pacific Colorectal Screening (APCS) score). Three tiers of risk were arbitrarily defined: 0-1 'average risk' (AR); 2-3 'moderate risk' (MR); and 4-7 'high risk' (HR). Subjects undergoing screening colonoscopy between July 2006 and December 2007 were prospectively enrolled to form an independent validation group. Each subject had a personal APCS score calculated by summing the points attributed from the presence of risk factors in the individuals. The performance of the APCS score in predicting risk of advanced neoplasia was evaluated. Results: There were 860 subjects in the derivation set and 1892 subjects in the validation set, with a baseline prevalence of advanced neoplasia of 4.5% and 3%, respectively. Applying the APCS stratification in the validation set, 559 subjects (29.5%) were in the AR tier, 966 subjects (51.1%) in the MR tier and 367 (19.4%) subjects in the HR tier. The prevalence of advanced neoplasia in the AR, MR and HR groups was 1.3, 3.2 and 5.2%, respectively. The subjects in the MR and HR tiers had 2.6-fold (95% CI 1.1 to 6.0) and 4.3-fold (95% CI 1.8 to 10.3) increased prevalence of advanced neoplasia, respectively, than those in the AR tier. Conclusions: The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.
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U2 - 10.1136/gut.2010.221168
DO - 10.1136/gut.2010.221168
M3 - Article
C2 - 21402615
AN - SCOPUS:80051551174
SN - 0017-5749
VL - 60
SP - 1236
EP - 1241
JO - Gut
JF - Gut
IS - 9
ER -