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A New Scoring System to Predict the Risk for High-risk Adenoma and Comparison of Existing Risk Calculators
- Source :
- Journal of Clinical Gastroenterology. 51:345-351
- Publication Year :
- 2017
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2017.
-
Abstract
- BACKGROUND Colorectal cancer (CRC) screening guidelines likely over-generalizes CRC risk, 35% of Americans are not up to date with screening, and there is growing incidence of CRC in younger patients. GOALS We developed a practical prediction model for high-risk colon adenomas in an average-risk population, including an expanded definition of high-risk polyps (≥3 nonadvanced adenomas), exposing higher than average-risk patients. We also compared results with previously created calculators. STUDY Patients aged 40 to 59 years, undergoing first-time average-risk screening or diagnostic colonoscopies were evaluated. Risk calculators for advanced adenomas and high-risk adenomas were created based on age, body mass index, sex, race, and smoking history. Previously established calculators with similar risk factors were selected for comparison of concordance statistic (c-statistic) and external validation. RESULTS A total of 5063 patients were included. Advanced adenomas, and high-risk adenomas were seen in 5.7% and 7.4% of the patient population, respectively. The c-statistic for our calculator was 0.639 for the prediction of advanced adenomas, and 0.650 for high-risk adenomas. When applied to our population, all previous models had lower c-statistic results although one performed similarly. CONCLUSIONS Our model compares favorably to previously established prediction models. Age and body mass index were used as continuous variables, likely improving the c-statistic. It also reports absolute predictive probabilities of advanced and high-risk polyps, allowing for more individualized risk assessment of CRC.
- Subjects :
- Adenoma
Adult
Male
medicine.medical_specialty
Cross-sectional study
Concordance
Population
Colonoscopy
Risk Assessment
03 medical and health sciences
0302 clinical medicine
Risk Factors
Internal medicine
Prevalence
medicine
Humans
education
education.field_of_study
Models, Statistical
medicine.diagnostic_test
business.industry
Incidence (epidemiology)
Gastroenterology
Middle Aged
medicine.disease
digestive system diseases
Cross-Sectional Studies
030220 oncology & carcinogenesis
Florida
Female
030211 gastroenterology & hepatology
Colorectal Neoplasms
Risk assessment
business
Body mass index
Subjects
Details
- ISSN :
- 01920790
- Volume :
- 51
- Database :
- OpenAIRE
- Journal :
- Journal of Clinical Gastroenterology
- Accession number :
- edsair.doi.dedup.....30ffc1eb30b37058ab18d5b2ec602851