The Performance of Asia-Pacific Colorectal Screenings Score in Predicting Advanced Colorectal Neoplasia in Vietnamese Patients With Lower Bowel Symptoms

Abstract

The Asia-Pacific colorectal screening score (APCS) was recently developed to predict the risk of advanced colorectal neoplasia (ACN) in asymptomatic Asians. This study aims to: (1) define the prevalence of ACN; (2) evaluate the performance of APCS in predicting the risk of ACN in Vietnamese patients with lower bowel symptoms. Consecutive patients with lower bowel symptoms undergoing colonoscopy from January to May 2012 were prospectively enrolled in this cross-sectional study. APCS score for each patient was calculated by summing the points attributed by risk factors. Three tiers of risk were arbitrarily defined: 0–1 “average risk” (AR); 2–3 “moderate risk” (MR); 4–7 “high risk” (HR). The performance of APCS score in predicting risk of ACN was evaluated. Overall, 246 patients with excellent bowel preparation, and who had undergone complete colon examination were included (mean age, 47.8±14 years; male/female ratio, 1:1). Familial history of colorectal cancer was present in 5.3% (13/246) of subjects. The prevalence of ACN was 12.2% (30/246). Overall, 93 patients (37.8%) were in the AR tier, 104 (42.3%) in the MR tier and 49 (19.9%) in the HR tier. The prevalence of ACN in the AR, MR and HR groups was 3.2%, 14.4% and 23.5%, respectively. The prevalence of ACN in the MR and HR tiers was 5-fold (95% CI, 1.4–18.0) and 9.7-fold (95% CI, 2.6–36.5) that in the AR tier. The APCS score was useful in identifying patients with lower bowel symptoms at high risk of ACN in a cohort of Vietnamese population.