S1020 BMI and Advanced Colorectal Neoplasia in Average Risk Women: Results of Screening Colonoscopy in a Diverse Population Using a High Resolution Colonoscope

2008 ◽  
Vol 134 (4) ◽  
pp. A-160 ◽  
Author(s):  
Joseph C. Anderson ◽  
Benjamin Stein ◽  
Ramona Rajapakse ◽  
Zvi A. Alpern
Keyword(s):  
High Resolution ◽  
Colorectal Neoplasia ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Diverse Population ◽  
Advanced Colorectal Neoplasia

Derivation and validation of a predictive model for advanced colorectal neoplasia in asymptomatic adults

Gut ◽  
2020 ◽  
pp. gutjnl-2020-321698
Author(s):  
Thomas F Imperiale ◽  
Patrick O Monahan ◽  
Timothy E Stump ◽  
David F Ransohoff
Keyword(s):  
High Risk ◽  
Colorectal Neoplasia ◽  
Risk Groups ◽  
Low Risk ◽  
Screening Tests ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Intermediate Risk ◽  
C Statistic ◽  
Advanced Colorectal Neoplasia

ObjectiveKnowing risk for advanced colorectal neoplasia (AN) could help patients and providers choose among screening tests, improving screening efficiency and uptake. We created a risk prediction model for AN to help decide which test might be preferred, a use not considered for existing models.DesignAverage-risk 50-to-80-year olds undergoing first-time screening colonoscopy were recruited from endoscopy units in Indiana. We measured sociodemographic and physical features, medical and family history and lifestyle factors and linked these to the most advanced finding. We derived a risk equation on two-thirds of the sample and assigned points to each variable to create a risk score. Scores with comparable risks were collapsed into risk categories. The model and score were tested on the remaining sample.ResultsAmong 3025 subjects in the derivation set (mean age 57.3 (6.5) years; 52% women), AN prevalence was 9.4%. The 13-variable model (c-statistic=0.77) produced three risk groups with AN risks of 1.5% (95% CI 0.72% to 2.74%), 7.06% (CI 5.89% to 8.38%) and 27.26% (CI 23.47% to 31.30%) in low-risk, intermediate-risk and high-risk groups (p value <0.001), containing 23%, 59% and 18% of subjects, respectively. In the validation set of 1475 subjects (AN prevalence of 8.4%), model performance was comparable (c-statistic=0.78), with AN risks of 2.73% (CI 1.25% to 5.11%), 5.57% (CI 4.12% to 7.34%) and 25.79% (CI 20.51% to 31.66%) in low-risk, intermediate-risk and high-risk subgroups, respectively (p<0.001), containing proportions of 23%, 59% and 18%.ConclusionAmong average-risk persons, this model estimates AN risk with high discrimination, identifying a lower risk subgroup that may be screened non-invasively and a higher risk subgroup for which colonoscopy may be preferred. The model could help guide patient–provider discussions of screening options, may increase screening adherence and conserve colonoscopy resources.

Prevalence of advanced colorectal neoplasia according to risk categories at screening colonoscopy in a tertiary referral center.

2018 ◽  
Vol 36 (4_suppl) ◽  
pp. 578-578
Author(s):  
Eduardo Negrete Carballo ◽  
Fidel David Huitzil Melendez
Keyword(s):  
Colorectal Cancer ◽  
High Risk ◽  
Risk Stratification ◽  
Colorectal Neoplasia ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Moderate Risk ◽  
Advanced Colorectal Neoplasia ◽  
Advanced Neoplasm ◽  
Colorectal Screening

578 Background: Colorectal cancer (CRC) is the third most common cancer in the world. There is strong evidence that screening for colorectal cancer improves survival in conutries with high incidence. Although Mexico is considered a country with a low incidence of CRC, 4694 potentially preventable deaths occur every year. There is no established CRC screening program in our country, risk stratification of the target populations to be screened may bring potential advantages, making the strategy more cost-effective. The Asia-Pacific Colorectal Screening (APCS) score, is a validated risk-stratification tool that helps identify individuals at risk for advanced colorectal neoplasm amongst the asymptomatic population. Methods: We performed a retrospective, cross-sectional analysis of database records from 1172 patients who underwent screening colonoscopy betwen january 2013 and november 2014. Results: The prevalence of advanced colorectal neoplasia was 2.9%. Applying the APCS stratification, 91 subjects (7.8%) were in the average risk tier, 849 subjects (72.4%) in the moderate risk tier and 232 (19.8%) subjects in the high risk tier. The prevalence of advanced neoplasia in the average risk, moderate risk and high risk groups was 0%, 2.6% and 5.1%, respectively. The subjects in the high risk tier had 2.21-fold (p = 0.021) increased prevalence of advanced neoplasia than those in the average-moderate tier. Conclusions: The APCS score is a simple risk stratification index for colorectal advanced neoplasm that uses elementary clinical information on age, gender, family history and smoking to stratify the risk of colorectal advanced neoplasm in asymptomatic subjects for priority of colorectal screening.

scholarly journals A Risk Prediction Index for Advanced Colorectal Neoplasia at Screening Colonoscopy

2015 ◽  
Vol 110 (7) ◽  
pp. 1062-1071 ◽  
Author(s):  
Paul C Schroy ◽  
John B Wong ◽  
Michael J OʼBrien ◽  
Clara A Chen ◽  
John L Griffith
Keyword(s):  
Risk Prediction ◽  
Colorectal Neoplasia ◽  
Screening Colonoscopy ◽  
Advanced Colorectal Neoplasia

Predictors of advanced colorectal neoplasia in colorectal cancer screening – interim results of multicentric prospective study

2020 ◽  
Vol 74 (5) ◽  
pp. 386-392
Author(s):  
Tomáš Grega ◽  
Gabriela Vojtěchová ◽  
Michal Voška ◽  
Ondřej Májek ◽  
Miroslav Zavoral ◽  
...  
Keyword(s):  
Risk Factors ◽  
Vitamin D ◽  
Prospective Study ◽  
Colorectal Neoplasia ◽  
Serum Triglyceride ◽  
Screening Colonoscopy ◽  
Factors Associated ◽  
Primary Screening ◽  
Advanced Colorectal Neoplasia ◽  
Screening Population

ntroduction: The incidence of advanced colorectal neoplasia in the screening population shows great diversity with a prevalence of 3–12 %. Due to the uneven distribution in the population, potential risk factors that would allow the stratification of individuals according to the degree of risk of colorectal neoplasia are searched. Aim: To determine the risk factors associated with the occurrence of advanced colorectal neoplasia in the screening population. Methods: Asymptomatic individuals aged 45–75 years who underwent preventive colonoscopy in 2012–2016 in a multicenter prospective study monitoring metabolic risk factors for CRC (MRF CRC study) were included in the analysis. Data were analyzed using descriptive statistics. The Fisher’s exact test was used to compare the risk factors with the occurrence of advanced colorectal neoplasia. Results: There were 1,108 men (56.3%) and 859 women (43.7%) in the group; the average age of the individuals was 60 years. The majority of subjects were referred for primary screening colonoscopy (1,174 subjects; 59.7%) and 793 subjects (40.3%) underwent FOBT positive colonoscopy. The total number of advanced colorectal neoplasms in the cohort was 11,8% (233 individuals). The independent risk factors significantly associated with advanced colorectal neoplasia included age (p < 0.001), male gender (p = 0.001), smoking (p < 0.001), serum concentrations of triglycerides (p = 0.029; especially concentrations > 2 mmol/l) and low vitamin D (p = 0.033). These are preliminary results which will be specified in the following more detailed data analysis using logistic regression. Conclusion: The strongest risk factors associated with advanced colorectal neoplasia were age, gender and smoking. In addition to these factors, serum triglyceride levels and low vitamin D were significantly associated with advanced colorectal neoplasia. In the individuals with a higher incidence of advanced colorectal neoplasia according to the given factors, primary screening colonoscopy should be considered.

Prospective assessment of the risk for colorectal neoplasia in a Mexican population according to risk categories.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e15158-e15158
Author(s):  
Vanessa Rosas Camargo ◽  
Edgar Omar Martos Armendariz ◽  
Mauricio Rivera Aguilar ◽  
Jorge Humberto Hernandez-Felix ◽  
Monica Lily Cordon ◽  
...  
Keyword(s):  
Family History ◽  
High Risk ◽  
Screening Program ◽  
Smoking Status ◽  
Colorectal Neoplasia ◽  
Asia Pacific ◽  
Screening Colonoscopy ◽  
Average Risk ◽  
Prospective Assessment ◽  
History Of

e15158 Background: General population screening can reduce colorectal cancer (CRC) mortality. International guidelines recommend CRC screening for asymptomatic people over 50 years. There is no established national screening program in Mexico. Even in countries with low incidence of CRC such as Mexico, targeted screening of subjects at high risk could decrease resource utilization and cost. Our aim was to describe the distribution among an average-risk population based on risk for colorectal neoplasia (CRN). Methods: We performed a prospective assessment of the risk for CRN among asymptomatic people over 50 years at Instituto Nacional de Ciencias Médicas y Nutrición between 2017-2018. The inclusion was competitive consistent with our age-sex pyramid. We included workers, non-family attendants and patients (internal medicine consultation). Each subject answered a standardized questionnaire, which included information on their age, gender, family history of CRC, diabetes, body mass index (BMI), smoking status and drinking habits. In order to stratify the population according to their risk for CRN, we used the Asia-Pacific Colorectal Screening (APCS) score. Results: We included 256 subjects. Median age was 59 y/o (50-93), 52% were female. 5% had a first-degree relative with CRC. 44% were current or ex-smoker and 9% reported alcohol consumption. 21% had diabetes. The median BMI was 27.3 (17-51). According to the APCS score, 60% were assigned as average risk (AR) and 40% as high risk (HR) for CRN. We observed a higher proportion of HR compared to our previous retrospective data (Table). Conclusions: We prospectively confirmed that using basic clinical information (age, gender, smoking status, family history of CRC, BMI and diabetes), it is possible to identify a subset of asymptomatic subjects at high risk for CRN in whom screening strategies should be prioritized. In developing countries with limited resources, a focus on high risk groups could improve cost effectiveness of screening colonoscopy. Risk stratification based on APCS score. [Table: see text]

Su1227 Prevalence of Colorectal Neoplasia in Asymptomatic Average-Risk Individuals Aged 40-49 Years Undergoing Screening Colonoscopy

2014 ◽  
Vol 146 (5) ◽  
pp. S-407
Author(s):  
Ari Leshno ◽  
Menachem Moshkowitz ◽  
Aharon Hallak ◽  
Roman Grinshpoon ◽  
Erwin Santo ◽  
...  
Keyword(s):  
Colorectal Neoplasia ◽  
Screening Colonoscopy ◽  
Average Risk
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