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Scoring system predicted colonoscopic detection of advanced colorectal neoplasia
Researchers from Poland have developed a scoring system based on simple clinical factors that successfully estimated the likelihood of advanced colorectal neoplasia detection by colonoscopy in asymptomatic patients.
To derive a risk prediction model for their system, the researchers performed a cross-sectional analysis of data from the national colorectal cancer (CRC) screening program on patients aged 40 to 66 years who enrolled in 2007. Using a test set (n=17,979) and validation set (n=17,939) they investigated associations between the presence of advanced colorectal neoplasia (ACN) and the following questionnaire-culled potential risk factors: age, sex, BMI, first-degree family history of CRC, diabetes mellitus, smoking history and regular aspirin use.
Among 35,918 included patients (mean age 55.6 years, 61.7% women, 100% Caucasian), ACN was detected in 7.1% of patients, including 0.9% with adenocarcinoma. Significant associations between risk for ACN detection and age, sex, family history of CRC, smoking (all P<.001) and BMI (P=.033) were observed. Scores were calculated for each patient in the validation set, ranging from 1.32% likelihood for ACN detection in patients with a score of zero, to 19.12% likelihood for patients with scores from seven to eight. The ratio of expected to observed risk for ACN in the validation set was well calibrated (1; 95% CI, 0.95-1.06) and the scoring system had a moderately discriminating concordance statistic (0.62; 95% CI, 0.6-0.64).
“We derived and internally validated a model that predicts the likelihood of detecting ACN in asymptomatic Caucasian patients,” the researchers concluded. “Once externally validated, the score may be useful for counseling or designing primary prevention studies.”
Disclosure: The researchers report no relevant financial disclosures.