title: Predictors of advanced colorectal neoplasia for colorectal cancer screening.
abstract: BACKGROUND
  The Asia-Pacific Colorectal Screening (APCS) score based on age, gender, family history, and smoking is useful to predict advanced colorectal neoplasia (ACN) in asymptomatic Asian subjects.
  
  
  OBJECTIVE
  To evaluate the factors in addition to those of APCS associated with ACN colonoscopic findings.
  
  
  METHODS
  Data from 5,220 asymptomatic subjects aged between 50 and 70 years who underwent screening colonoscopy in a community center between 2008 and 2012 were analyzed. One binary logistic regression analysis was conducted in 2013 with the presence of ACN or cancer as the outcome, controlling for APCS score, alcohol consumption, BMI, hypertension, and other chronic diseases as independent variables.
  
  
  RESULTS
  The average participant age was 57.7 years (SD=4.9) and 47.5% were men. Advanced neoplasms or cancers were identified at colonoscopy in 5.6% of all screening participants. From multivariate regression analysis, APCS score≥4 (adjusted OR [AOR]=1.74, 95% CI=1.34, 2.25, p<0.001); overweight (BMI=23-24.9, AOR=1.52, 95% CI=1.12, 2.07, p=0.007); obesity (BMI≥25, AOR=1.56, 95% CI=1.15, 2.10, p=0.004); hypertension (AOR=1.58, 95% CI=1.21, 2.06, p=0.001); and alcohol consumption (AOR=1.47, 95% CI=1.05, 2.06, p=0.025) were associated with ACN. The c-statistic of APCS score alone was 0.560 (95% CI=0.524, 0.595, p=0.001) and that of APCS score plus BMI, hypertension, and alcohol consumption was 0.613 (95% CI=0.578, 0.648, p<0.001).
  
  
  CONCLUSIONS
  Alcohol consumption, hypertension, and BMI are independent predictors of ACN, which could be incorporated into the APCS for prioritizing Asian asymptomatic subjects for colorectal cancer screening.
authors.affiliation: Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong; School of Public Health and Primary Care, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.affiliation: Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: Thomas Y T
authors.initials: TY
authors.lastname: Lam
authors.affiliation: Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: Kelvin K F
authors.initials: KK
authors.lastname: Tsoi
authors.affiliation: Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: Victor C W
authors.initials: VC
authors.lastname: Chan
authors.affiliation: Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: Hoyee W
authors.initials: HW
authors.lastname: Hirai
authors.affiliation: Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong.
authors.forename: Jessica Y L
authors.initials: JY
authors.lastname: Ching
authors.affiliation: Institute of Digestive Disease, Faculty of Medicine, Chinese University of Hong Kong, Prince of Wales Hospital, Shatin NT, Hong Kong. Electronic address: jjysung@cuhk.edu.hk.
authors.forename: Joseph J Y
authors.initials: JJ
authors.lastname: Sung
mesh_terms: D000367:Age Factors; D000368:Aged; D000428:Alcohol Drinking / Q000453:epidemiology; D001208:Asia / Q000453:epidemiology; D015992:Body Mass Index; D003113:Colonoscopy / Q000706:statistics & numerical data; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D015897:Comorbidity; D004032:Diet; D055088:Early Detection of Cancer; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012307:Risk Factors; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology