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A scoring model for predicting advanced colorectal neoplasia in a screened population of asymptomatic Japanese individuals

Journal of Gastroenterology volume 53, pages 1109–1119 (2018)Cite this article

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Abstract

Background

Risk stratification of screened populations could help improve colorectal cancer (CRC) screening. Use of the modified Asia-Pacific Colorectal Screening (APCS) score has been proposed in the Asia-Pacific region. This study was performed to build a new useful scoring model for CRC screening.

Methods

Data were reviewed from 5218 asymptomatic Japanese individuals who underwent their first screening colonoscopy. Multivariate logistic regression was used to investigate risk factors for advanced colorectal neoplasia (ACN), and a new scoring model for the prediction of ACN was developed based on the results. The discriminatory capability of the new model and the modified APCS score were assessed and compared. Internal validation was also performed.

Results

ACN was detected in 225 participants. An 8-point scoring model for the prediction of ACN was developed using five independent risk factors for ACN (male sex, higher age, presence of two or more first-degree relatives with CRC, body mass index of > 22.5 kg/m2, and smoking history of > 18.5 pack-years). The prevalence of ACN was 1.6% (34/2172), 5.3% (127/2419), and 10.2% (64/627) in participants with scores of < 3, ≥ 3 to < 5, and ≥ 5, respectively. The c-statistic of the scoring model was 0.70 (95% confidence interval, 0.67–0.73) in both the development and internal validation sets, and this value was higher than that of the modified APCS score [0.68 (95% confidence interval, 0.65–0.71), P = 0.03].

Conclusions

We built a new simple scoring model for prediction of ACN in a Japanese population that could stratify the screened population into low-, moderate-, and high-risk groups.

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Acknowledgements

This study was supported by JSPS KAKENHI, grant number 17K15978 and the National Cancer Center Research and Development Fund (27-A-5). The authors thank Angela Morben, DVM, ELS, from Edanz Group (www.edanzediting.com/ac) for editing a draft of this manuscript.

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Authors and Affiliations

  1. Cancer Screening Center, National Cancer Center Hospital, 5-1-1 Tsukiji, Chuo-ku, Tokyo, 104-0045, Japan

    Masau Sekiguchi & Takahisa Matsuda

  2. Division of Screening Technology, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan

    Masau Sekiguchi & Takahisa Matsuda

  3. Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan

    Masau Sekiguchi, Yasuo Kakugawa, Minori Matsumoto & Takahisa Matsuda

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  1. Masau Sekiguchi
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  2. Yasuo Kakugawa
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  4. Takahisa Matsuda
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Correspondence to Masau Sekiguchi.

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Sekiguchi, M., Kakugawa, Y., Matsumoto, M. et al. A scoring model for predicting advanced colorectal neoplasia in a screened population of asymptomatic Japanese individuals. J Gastroenterol 53, 1109–1119 (2018). https://doi.org/10.1007/s00535-018-1433-7

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  • DOI: https://doi.org/10.1007/s00535-018-1433-7

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