Prospective Study of a Risk Score in the Prediction of Advanced Colorectal Neoplasia at Colonoscopy

Abstract

Background and AimsWe aimed to validate a clinical risk score predictive of risk for advanced colorectal neoplasia in an asymptomatic Australian population, and determine the viability of including body mass index (BMI) and ethnicity in the risk score.MethodsTwo hundred fifty asymptomatic patients undergoing screening colonoscopy were recruited from two Australian endoscopy centers. Multivariate logistic regression was applied to identify significant risk factors for colorectal adenoma and advanced neoplasia. The Asia-Pacific Colorectal Screening (APCS) score – based on age, gender, family history and smoking – was applied to all patients. The performance of the APCS score in the prediction of colorectal adenoma and advanced neoplasia was evaluated. BMI and ethnicity were also evaluated as possible inclusions within the risk score.ResultsForty four (17.6%) subjects were in the average-risk (AR) group; 113 (45.4%) in the moderate-risk (MR) group; and 93 (37.2%) in the high-risk (HR) group. A total of 11 subjects were diagnosed with advanced neoplasia: 0 in the AR group; 3 (2.7%) in the MR group; and 8 (8.6%) in the HR group (P < .001). Patients in the MR group had a relative risk of advanced neoplasia of 2.0 (95% confidence interval [CI], .2–22.1) and patients in the HR group, 8.0 (95% CI, 1.0–64.0). BMI and ethnicity were not significant risk factors.ConclusionsThe APCS score is useful in predicting advanced colorectal neoplasia in an asymptomatic Australian population and can be used as a stratification tool in prioritization of colorectal screening. Background and AimsWe aimed to validate a clinical risk score predictive of risk for advanced colorectal neoplasia in an asymptomatic Australian population, and determine the viability of including body mass index (BMI) and ethnicity in the risk score. We aimed to validate a clinical risk score predictive of risk for advanced colorectal neoplasia in an asymptomatic Australian population, and determine the viability of including body mass index (BMI) and ethnicity in the risk score. MethodsTwo hundred fifty asymptomatic patients undergoing screening colonoscopy were recruited from two Australian endoscopy centers. Multivariate logistic regression was applied to identify significant risk factors for colorectal adenoma and advanced neoplasia. The Asia-Pacific Colorectal Screening (APCS) score – based on age, gender, family history and smoking – was applied to all patients. The performance of the APCS score in the prediction of colorectal adenoma and advanced neoplasia was evaluated. BMI and ethnicity were also evaluated as possible inclusions within the risk score. Two hundred fifty asymptomatic patients undergoing screening colonoscopy were recruited from two Australian endoscopy centers. Multivariate logistic regression was applied to identify significant risk factors for colorectal adenoma and advanced neoplasia. The Asia-Pacific Colorectal Screening (APCS) score – based on age, gender, family history and smoking – was applied to all patients. The performance of the APCS score in the prediction of colorectal adenoma and advanced neoplasia was evaluated. BMI and ethnicity were also evaluated as possible inclusions within the risk score. ResultsForty four (17.6%) subjects were in the average-risk (AR) group; 113 (45.4%) in the moderate-risk (MR) group; and 93 (37.2%) in the high-risk (HR) group. A total of 11 subjects were diagnosed with advanced neoplasia: 0 in the AR group; 3 (2.7%) in the MR group; and 8 (8.6%) in the HR group (P < .001). Patients in the MR group had a relative risk of advanced neoplasia of 2.0 (95% confidence interval [CI], .2–22.1) and patients in the HR group, 8.0 (95% CI, 1.0–64.0). BMI and ethnicity were not significant risk factors. Forty four (17.6%) subjects were in the average-risk (AR) group; 113 (45.4%) in the moderate-risk (MR) group; and 93 (37.2%) in the high-risk (HR) group. A total of 11 subjects were diagnosed with advanced neoplasia: 0 in the AR group; 3 (2.7%) in the MR group; and 8 (8.6%) in the HR group (P < .001). Patients in the MR group had a relative risk of advanced neoplasia of 2.0 (95% confidence interval [CI], .2–22.1) and patients in the HR group, 8.0 (95% CI, 1.0–64.0). BMI and ethnicity were not significant risk factors. ConclusionsThe APCS score is useful in predicting advanced colorectal neoplasia in an asymptomatic Australian population and can be used as a stratification tool in prioritization of colorectal screening. The APCS score is useful in predicting advanced colorectal neoplasia in an asymptomatic Australian population and can be used as a stratification tool in prioritization of colorectal screening.