A risk scoring system for advanced colorectal neoplasia in high-risk participants to improve current colorectal cancer screening in Tianjin, China.

Tytuł:: A risk scoring system for advanced colorectal neoplasia in high-risk participants to improve current colorectal cancer screening in Tianjin, China.
Autorzy:: Yuan Z; School of Medicine, Nankai University, Tianjin, China.
Wang S; School of Medicine, Nankai University, Tianjin, China.
Liu Z; School of Medicine, Nankai University, Tianjin, China.; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China.
Liu Y; School of Integrative Medicine, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Wang Y; School of Medicine, Nankai University, Tianjin, China.
Han Y; Department of General Surgery, Tianjin Union Medical Center, Tianjin, China.
Gao W; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China.
Liu X; Tianjin Medical University, Tianjin, China.
Li H; Department of Endoscopy, Tianjin Union Medical Center, Tianjin, China.
Zhang Q; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China.; The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China.; Tianjin Institute of Coloproctology, Tianjin, China.
Ma H; Nursing Department, Tianjin Union Medical Center, Tianjin, China.
Wang J; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China.
Wei X; Hospital Infection Management Division, Tianjin Union Medical Center, Tianjin, China.
Zhang X; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China. .; The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China. .; Tianjin Institute of Coloproctology, Tianjin, China. .
Cui W; School of Mathematical Sciences and LPMC, Nankai University, Tianjin, China. .
Zhang C; Department of Colorectal Surgery, Tianjin Union Medical Center, Tianjin, China. .; The Institute of Translational Medicine, Tianjin Union Medical Center of Nankai University, Tianjin, China. .; Tianjin Institute of Coloproctology, Tianjin, China. .
Źródło:: BMC gastroenterology [BMC Gastroenterol] 2022 Nov 17; Vol. 22 (1), pp. 466. Date of Electronic Publication: 2022 Nov 17.
Typ publikacji:: Journal Article
Język:: English
Imprint Name(s):: Original Publication: London : BioMed Central, [2001-
MeSH Terms:: Colorectal Neoplasms*/diagnosis
Colorectal Neoplasms*/epidemiology
Colorectal Neoplasms*/etiology
Early Detection of Cancer*/methods
Humans ; Male ; Middle Aged ; China/epidemiology ; Risk Factors ; Female
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Grant Information:: 2019ZZ07 Tianjin Hospital Association Hospital Management Research Project; 19YFZCSY00420 Key R&D Projects in the Tianjin Science and Technology Pillar Program; 2017YFC1700604 National key R&D Program of China; 21JCZDJC00060 Natural Science Foundation of Tianjin; TJYXZDXK-044A Tianjin Key Medical Discipline (Specialty) Construction Project
Contributed Indexing:: Keywords: Advanced colorectal neoplasia; Colorectal cancer; Risk scoring systems; Screening
Entry Date(s):: Date Created: 20221118 Date Completed: 20221122 Latest Revision: 20221122
Update Code:: 20240104
PubMed Central ID:: PMC9670427
DOI:: 10.1186/s12876-022-02563-9
PMID:: 36397000
: Czasopismo naukowe

Pełny tekst

Background: Given the limited effectiveness of the current Chinese colorectal cancer (CRC) screening procedure, adherence to colonoscopy remains low. We aim to develop and validate a scoring system based on individuals who were identified as having a high risk in initial CRC screening to achieve more efficient risk stratification and improve adherence to colonoscopy.
Methods: A total of 29,504 screening participants with positive High-Risk Factor Questionnaire (HRFQ) or faecal immunochemical test (FIT) who underwent colonoscopy in Tianjin from 2012-2020 were enrolled in this study. Binary regression analysis was used to evaluate the association between risk factors and advanced colorectal neoplasia. Internal validation was also used to assess the performance of the scoring system.
Results: Male sex, older age (age ≥ 50 years), high body mass index (BMI ≥ 28 kg/m 2 ), current or past smoking and weekly alcohol intake were identified as risk factors for advanced colorectal neoplasm. The odds ratios (ORs) for significant variables were applied to construct the risk score ranging from 0-11: LR, low risk (score 0-3); MR, moderate risk (score 4-6); and HR, high risk (score 7-11). Compared with subjects with LR, those with MR and HR had ORs of 2.47 (95% confidence interval, 2.09-2.93) and 4.59 (95% confidence interval, 3.86-5.44), respectively. The scoring model showed an outstanding discriminatory capacity with a c-statistic of 0.64 (95% confidence interval, 0.63-0.65).
Conclusions: Our results showed that the established scoring system could identify very high-risk populations with colorectal neoplasia. Combining this risk score with current Chinese screening methods may improve the effectiveness of CRC screening and adherence to colonoscopy.
(© 2022. The Author(s).)

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