A New Scoring System to Predict the Risk for High-risk Adenoma and Comparison of Existing Risk Calculators.
J Clin Gastroenterol
; 51(4): 345-351, 2017 Apr.
Article
em En
| MEDLINE
| ID: mdl-27322531
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.
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Neoplasias Colorretais
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Adenoma
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Modelos Estatísticos
Tipo de estudo:
Etiology_studies
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Guideline
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Observational_studies
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Prevalence_studies
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Prognostic_studies
/
Risk_factors_studies
Limite:
Adult
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Female
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Humans
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Male
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Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Revista:
J Clin Gastroenterol
Ano de publicação:
2017
Tipo de documento:
Article