title: Development and validation of a clinical score for predicting risk of adenoma at screening colonoscopy.
abstract: BACKGROUND
  Currently, no clinical tools use demographic and risk factor information to predict the risk of finding an adenoma in individuals undergoing colon cancer screening. Such a tool would be valuable for identifying those who would most benefit from screening colonoscopy.
  
  
  METHODS
  We used baseline data from men and women who underwent screening colonoscopy from the randomized, multicenter National Colonoscopy Study (NCS) to develop and validate an adenoma risk model. The study, conducted at three sites in the United States (Minneapolis, MN; Seattle, WA; and Shreveport, LA) asked all participants to complete baseline questionnaires on clinical risk factors and family history. Model parameters estimated from logistic regression yielded an area under the receiver operating characteristic curve (AUROCC) used to assess prediction.
  
  
  RESULTS
  Five hundred forty-one subjects were included in the development model, and 1,334 in the validation of the risk score. Variables in the prediction of adenoma risk for colonoscopy screening were age (likelihood ratio test for overall contribution to model, P < 0.001), male sex (P < 0.001), body mass index (P < 0.001), family history of at least one first-degree relative with colorectal cancer (P = 0.036), and smoking history (P < 0.001). The adjusted AUROCC of 0.67 [95% confidence interval (CI), 0.61-0.74] for the derivation cohort was not statistically significantly different from that in the validation cohort. The adjusted AUROCC for the entire cohort was 0.64 (95% CI, 0.60-0.67).
  
  
  CONCLUSIONS
  We developed and validated a simple well-calibrated risk score.
  
  
  CONCLUSIONS
  This tool may be useful for estimating risk of adenomas in screening eligible men and women.
authors: Section of Gastroenterology, VA Medical Center, Minneapolis, Minnesota. Department of Medicine, Yale University, New Haven, Connecticut. shaukat@umn.edu.
authors: Aasma
authors: A
authors: Shaukat
authors: Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota.
authors: Timothy R
authors: TR
authors: Church
authors: Division of Biostatistics, University of Minnesota, Minneapolis, Minnesota.
authors: Ryan
authors: R
authors: Shanley
authors: Ovarian Cancer Screening and Prevention, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Noah D
authors: ND
authors: Kauff
authors: Department of Pathology and Laboratory Medicine, Boston University, Boston, Massachusetts.
authors: Michael J
authors: MJ
authors: O'Brien
authors: Section of Hematology and Oncology, Louisiana State University Health, Shreveport, Louisiana.
authors: Glenn M
authors: GM
authors: Mills
authors: Department of Medicine, Louisiana State University Health, Shreveport, Louisiana.
authors: Paul A
authors: PA
authors: Jordan
authors: Department of Medicine, Yale University, New Haven, Connecticut. Minnesota Gastroenterology, PA, Minneapolis, Minnesota.
authors: John A
authors: JA
authors: Allen
authors: Minnesota Gastroenterology, PA, Minneapolis, Minnesota.
authors: Adam
authors: A
authors: Kim
authors: Department of Gastroenterology, Group Health Cooperative, Seattle, Washington.
authors: Andrew D
authors: AD
authors: Feld
authors: Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Ann Graham
authors: AG
authors: Zauber
authors: Department of Gastroenterology and Nutrition Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors: Sidney J
authors: SJ
authors: Winawer
mesh_terms: D000236:Adenoma / Q000175:diagnosis* / Q000453:epidemiology*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D009367:Neoplasm Staging; D011379:Prognosis; D018570:Risk Assessment; D012307:Risk Factors; D014481:United States / Q000453:epidemiology