title: Utility of the Asia-Pacific colorectal screening scoring system and the presence of metabolic syndrome components in screening for sporadic colorectal cancer.
abstract: OBJECTIVE
  To determine the utility of the Asia-Pacific colorectal screening (APCS) scoring system and metabolic syndrome components in individual screening for sporadic colorectal cancer.
  
  
  METHODS
  The subjects were patients admitted to the Peking University People's Hospital for colonoscopy between October 2012 and July 2013. Clinical information, including patient willingness to undergo colonoscopy, medical history, endoscopic findings, histology, and other information, was collected, and the patients were grouped according to APCS scores and the presence of metabolic syndrome components. Colorectal tumor detection rates were compared between the groups.
  
  
  RESULTS
  A total of 219 patients were included in the study, 108 were male and 111 were female, resulting in a male-to-female ratio of 1:1.03. The average age of the patients was 56.8 ± 13.7 years. According to APCS scores, 88 (40.2%) patients were included in the average-risk (AR) group, 113 (51.6%) patients were included in the moderate-risk (MR) group, and 18 (8.2%) patients were included in the high-risk (HR) group. Colorectal tumors were detected in 69 (31.5%) subjects, and the detection rates in the AR, MR, and HR groups were 15.9%, 36.3%, and 77.8%, respectively. The difference in the detection rates between the three groups was statistically significant (P < 0.01). The combined detection rate of colorectal tumors in the APCS MR and HR groups was 42.0%. However, patients in the MR and HR groups who presented with metabolic syndrome components, in particular obesity, exhibited a significantly higher colorectal tumor detection rate (59.5%) than did those without these components (19.2%, P < 0.01) and those who underwent colonoscopy because of doctor's recommendation (36.5%, P < 0.01).
  
  
  CONCLUSIONS
  The APCS scoring system can be used in individual screening for sporadic colorectal cancer. The combined use of APCS scores and the metabolic syndrome components, in particular obesity, will significantly improve the efficacy of individual colorectal cancer screening.
authors.affiliation: Jiang-Yuan Wang, Yuan-Min Zhu, Yu-Lan Liu, Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Jiang-Yuan
authors.initials: JY
authors.lastname: Wang
authors.affiliation: Jiang-Yuan Wang, Yuan-Min Zhu, Yu-Lan Liu, Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Zhen-Tao
authors.initials: ZT
authors.lastname: Li
authors.affiliation: Jiang-Yuan Wang, Yuan-Min Zhu, Yu-Lan Liu, Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Yuan-Min
authors.initials: YM
authors.lastname: Zhu
authors.affiliation: Jiang-Yuan Wang, Yuan-Min Zhu, Yu-Lan Liu, Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Wen-Chao
authors.initials: WC
authors.lastname: Wang
authors.affiliation: Jiang-Yuan Wang, Yuan-Min Zhu, Yu-Lan Liu, Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Ma
authors.affiliation: Jiang-Yuan Wang, Yuan-Min Zhu, Yu-Lan Liu, Department of Gastroenterology, Peking University People's Hospital, Beijing 100044, China.
authors.forename: Yu-Lan
authors.initials: YL
authors.lastname: Liu
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000453:epidemiology / Q000473:pathology*; D015897:Comorbidity; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D024821:Metabolic Syndrome / Q000175:diagnosis* / Q000453:epidemiology; D008875:Middle Aged; D009765:Obesity / Q000175:diagnosis / Q000453:epidemiology; D011237:Predictive Value of Tests; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors
keywords: Asia-Pacific colorectal screening scoring system; Colorectal cancer; Individual screening; Metabolic syndrome; Obesity