title: Use of colonoscopy as a primary screening test for colorectal cancer in average risk people.
abstract: OBJECTIVE
  The use of colonoscopy as a primary screening test for colorectal cancer (CRC) in average risk adults is a subject of controversy. Our primary objective was to build a predictive model based on a few simple variables that could be used as a guide for identifying average risk adults more suitable for examination with colonoscopy as a primary screening test.
  
  
  METHODS
  The prevalence of advanced adenomas was assessed by primary screening colonoscopy in 2210 consecutive adults at least 40 yr old, without known risk factors for CRC. Age, gender, and clinical and biochemical data were compared among people without adenomas, those with non-advanced adenomas, and those with any advanced neoplasm. A combined score to assess the risk of advanced adenomas was built with the variables selected by multiple logistic regression analysis.
  
  
  RESULTS
  Neoplastic lesions were found in 617 subjects (27.9%), including 259 with at least one neoplasm that was 10 mm or larger, villous, or with moderate-to-severe dysplasia, and 11 with invasive cancers. Advanced lesions were more frequent among men, older people, and those with a higher body mass index (BMI). These three variables were independent predictors of advanced adenomas in multivariate analysis. A score combining age, sex, and BMI was developed as a guide for identifying individuals more suitable for screening colonoscopy.
  
  
  CONCLUSIONS
  Age, gender, and BMI can be used to build a simple score to select those average risk adults who might be candidates for primary screening colonoscopy.
authors.affiliation: Department of Gastroenterology, University Clinic, University of Navarra, 31080 Pamplona, Spain.
authors.forename: Maite
authors.initials: M
authors.lastname: Betés
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Muñoz-Navas
authors.forename: José M
authors.initials: JM
authors.lastname: Duque
authors.forename: Ramón
authors.initials: R
authors.lastname: Angós
authors.forename: Elena
authors.initials: E
authors.lastname: Macías
authors.forename: Jose C
authors.initials: JC
authors.lastname: Súbtil
authors.forename: Maite
authors.initials: M
authors.lastname: Herraiz
authors.forename: Susana
authors.initials: S
authors.lastname: De La Riva
authors.forename: Miguel
authors.initials: M
authors.lastname: Delgado-Rodríguez
authors.forename: Miguel A
authors.initials: MA
authors.lastname: Martínez-González
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology; D000328:Adult; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003111:Colonic Polyps / Q000175:diagnosis / Q000453:epidemiology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment