Improvement of Asia-Pacific colorectal screening score and evaluation of its use combined with fecal immunochemical test
Abstract Background The Asia-Pacific Colorectal Screening (APCS) score is effective to screen high-risk groups of advanced colorectal neoplasia (ACN) patients but needs revising and can be combined with the fecal immunochemical test (FIT). This paper aimed to improve the APCS score and evaluate its...
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| Format: | Article |
| Language: | English |
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BMC
2019-12-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-019-1146-2 |
| _version_ | 1818665869197180928 |
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| author | Xu-xia He Si-yi Yuan Wen-bin Li Hong Yang Wen Ji Zhi-qiang Wang Jian-yu Hao Chuan Chen Wei-qing Chen Ying-xin Gao Ling-bo Li Kai-liang Cheng Jia-ming Qian Li Wang Jing-nan Li |
| author_facet | Xu-xia He Si-yi Yuan Wen-bin Li Hong Yang Wen Ji Zhi-qiang Wang Jian-yu Hao Chuan Chen Wei-qing Chen Ying-xin Gao Ling-bo Li Kai-liang Cheng Jia-ming Qian Li Wang Jing-nan Li |
| author_sort | Xu-xia He |
| collection | DOAJ |
| description | Abstract Background The Asia-Pacific Colorectal Screening (APCS) score is effective to screen high-risk groups of advanced colorectal neoplasia (ACN) patients but needs revising and can be combined with the fecal immunochemical test (FIT). This paper aimed to improve the APCS score and evaluate its use with the FIT in stratifying the risk of ACN. Methods This prospective and multicenter study enrolled 955 and 1201 asymptomatic Chinese participants to form the derivation and validation set, respectively. Participants received the risk factor questionnaire, colonoscopy and FIT. Multiple logistic regression was applied, and C-statistic, sensitivity and negative predictive values (NPVs) were used to compare the screening efficiency. Results A modified model was developed incorporating age, body mass index (BMI), family history, diabetes, smoking and drinking as risk factors, stratifying subjects into average risk (AR) or high risk (HR). In the validation set, the HR tier group had a 3.4-fold (95% CI 1.8–6.4) increased risk for ACN. The C-statistic for the modified score was 0.69 ± 0.04, and 0.67 ± 0.04 for the original score. The sensitivity of the modified APCS score combined with FIT for screening ACN high-risk cohorts was 76.7% compared with 36.7% of FIT alone and 70.0% of the modified APCS score alone. The NPVs of the modified score combined with FIT for ACN were 98.0% compared with 97.0% of FIT alone and 97.9% of the modified APCS score alone. Conclusions The modified score and its use with the FIT are efficient in selecting the HR group from a Chinese asymptomatic population. |
| first_indexed | 2024-12-17T05:55:29Z |
| format | Article |
| id | doaj.art-ec837c327aa24955993481446f644a7e |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-17T05:55:29Z |
| publishDate | 2019-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-ec837c327aa24955993481446f644a7e2022-12-21T22:01:03ZengBMCBMC Gastroenterology1471-230X2019-12-011911910.1186/s12876-019-1146-2Improvement of Asia-Pacific colorectal screening score and evaluation of its use combined with fecal immunochemical testXu-xia He0Si-yi Yuan1Wen-bin Li2Hong Yang3Wen Ji4Zhi-qiang Wang5Jian-yu Hao6Chuan Chen7Wei-qing Chen8Ying-xin Gao9Ling-bo Li10Kai-liang Cheng11Jia-ming Qian12Li Wang13Jing-nan Li14Department of Gastroenterology, Key Laboratory of Gut Microbiota Translational Medicine Research, Chinese Academy of Medical Science, Peking Union Medical College HospitalDepartment of Gastroenterology, Key Laboratory of Gut Microbiota Translational Medicine Research, Chinese Academy of Medical Science, Peking Union Medical College HospitalDepartment of Gastroenterology, Key Laboratory of Gut Microbiota Translational Medicine Research, Chinese Academy of Medical Science, Peking Union Medical College HospitalDepartment of Gastroenterology, Key Laboratory of Gut Microbiota Translational Medicine Research, Chinese Academy of Medical Science, Peking Union Medical College HospitalDepartment of Gastroenterology, Chongqing Cancer HospitalSecond Medical Center, Chinese PLA General HospitalDepartment of Gastroenterology, Beijing Chao-Yang HospitalDepartment of Gastroenterology, University of Hong Kong-Shenzhen HospitalDepartment of Gastroenterology, Chongqing Cancer HospitalDepartment of Gastroenterology, Beijing Chao-Yang HospitalMedical School of Nantong UniversityDepartment of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeDepartment of Gastroenterology, Key Laboratory of Gut Microbiota Translational Medicine Research, Chinese Academy of Medical Science, Peking Union Medical College HospitalDepartment of Epidemiology and Biostatistics, Institute of Basic Medical Sciences Chinese Academy of Medical Sciences, School of Basic Medicine Peking Union Medical CollegeDepartment of Gastroenterology, Key Laboratory of Gut Microbiota Translational Medicine Research, Chinese Academy of Medical Science, Peking Union Medical College HospitalAbstract Background The Asia-Pacific Colorectal Screening (APCS) score is effective to screen high-risk groups of advanced colorectal neoplasia (ACN) patients but needs revising and can be combined with the fecal immunochemical test (FIT). This paper aimed to improve the APCS score and evaluate its use with the FIT in stratifying the risk of ACN. Methods This prospective and multicenter study enrolled 955 and 1201 asymptomatic Chinese participants to form the derivation and validation set, respectively. Participants received the risk factor questionnaire, colonoscopy and FIT. Multiple logistic regression was applied, and C-statistic, sensitivity and negative predictive values (NPVs) were used to compare the screening efficiency. Results A modified model was developed incorporating age, body mass index (BMI), family history, diabetes, smoking and drinking as risk factors, stratifying subjects into average risk (AR) or high risk (HR). In the validation set, the HR tier group had a 3.4-fold (95% CI 1.8–6.4) increased risk for ACN. The C-statistic for the modified score was 0.69 ± 0.04, and 0.67 ± 0.04 for the original score. The sensitivity of the modified APCS score combined with FIT for screening ACN high-risk cohorts was 76.7% compared with 36.7% of FIT alone and 70.0% of the modified APCS score alone. The NPVs of the modified score combined with FIT for ACN were 98.0% compared with 97.0% of FIT alone and 97.9% of the modified APCS score alone. Conclusions The modified score and its use with the FIT are efficient in selecting the HR group from a Chinese asymptomatic population.https://doi.org/10.1186/s12876-019-1146-2Colorectal cancer screeningAdvanced colorectal neoplasiaPredictive modelFecal immunochemical testHigh risk population |
| spellingShingle | Xu-xia He Si-yi Yuan Wen-bin Li Hong Yang Wen Ji Zhi-qiang Wang Jian-yu Hao Chuan Chen Wei-qing Chen Ying-xin Gao Ling-bo Li Kai-liang Cheng Jia-ming Qian Li Wang Jing-nan Li Improvement of Asia-Pacific colorectal screening score and evaluation of its use combined with fecal immunochemical test BMC Gastroenterology Colorectal cancer screening Advanced colorectal neoplasia Predictive model Fecal immunochemical test High risk population |
| title | Improvement of Asia-Pacific colorectal screening score and evaluation of its use combined with fecal immunochemical test |
| title_full | Improvement of Asia-Pacific colorectal screening score and evaluation of its use combined with fecal immunochemical test |
| title_fullStr | Improvement of Asia-Pacific colorectal screening score and evaluation of its use combined with fecal immunochemical test |
| title_full_unstemmed | Improvement of Asia-Pacific colorectal screening score and evaluation of its use combined with fecal immunochemical test |
| title_short | Improvement of Asia-Pacific colorectal screening score and evaluation of its use combined with fecal immunochemical test |
| title_sort | improvement of asia pacific colorectal screening score and evaluation of its use combined with fecal immunochemical test |
| topic | Colorectal cancer screening Advanced colorectal neoplasia Predictive model Fecal immunochemical test High risk population |
| url | https://doi.org/10.1186/s12876-019-1146-2 |
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