title: A score to estimate the likelihood of detecting advanced colorectal neoplasia at colonoscopy.
abstract: OBJECTIVE
  This study aimed to develop and validate a model to estimate the likelihood of detecting advanced colorectal neoplasia in Caucasian patients.
  
  
  METHODS
  We performed a cross-sectional analysis of database records for 40-year-old to 66-year-old patients who entered a national primary colonoscopy-based screening programme for colorectal cancer in 73 centres in Poland in the year 2007. We used multivariate logistic regression to investigate the associations between clinical variables and the presence of advanced neoplasia in a randomly selected test set, and confirmed the associations in a validation set. We used model coefficients to develop a risk score for detection of advanced colorectal neoplasia.
  
  
  RESULTS
  Advanced colorectal neoplasia was detected in 2544 of the 35,918 included participants (7.1%). In the test set, a logistic-regression model showed that independent risk factors for advanced colorectal neoplasia were: age, sex, family history of colorectal cancer, cigarette smoking (p<0.001 for these four factors), and Body Mass Index (p=0.033). In the validation set, the model was well calibrated (ratio of expected to observed risk of advanced neoplasia: 1.00 (95% CI 0.95 to 1.06)) and had moderate discriminatory power (c-statistic 0.62). We developed a score that estimated the likelihood of detecting advanced neoplasia in the validation set, from 1.32% for patients scoring 0, to 19.12% for patients scoring 7-8.
  
  
  CONCLUSIONS
  Developed and internally validated score consisting of simple clinical factors successfully estimates the likelihood of detecting advanced colorectal neoplasia in asymptomatic Caucasian patients. Once externally validated, it may be useful for counselling or designing primary prevention studies.
authors.affiliation: Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Warsaw, Poland.
authors.forename: Michal F
authors.initials: MF
authors.lastname: Kaminski
authors.affiliation: Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Polkowski
authors.affiliation: Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Warsaw, Poland.
authors.forename: Ewa
authors.initials: E
authors.lastname: Kraszewska
authors.affiliation: Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Warsaw, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Rupinski
authors.affiliation: The Polish Foundation of Gastroenterology, Warsaw, Poland.
authors.forename: Eugeniusz
authors.initials: E
authors.lastname: Butruk
authors.affiliation: Department of Gastroenterological Oncology, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, Warsaw, Poland Department of Gastroenterology and Hepatology, Medical Centre for Postgraduate Education, Warsaw, Poland.
authors.forename: Jaroslaw
authors.initials: J
authors.lastname: Regula
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology; D000236:Adenoma / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology; D000328:Adult; D000368:Aged; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000209:etiology; D003430:Cross-Sectional Studies; D003661:Decision Support Techniques; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011044:Poland; D018570:Risk Assessment; D012307:Risk Factors; D011795:Surveys and Questionnaires; D044465:White People