title: The discriminatory capability of existing scores to predict advanced colorectal neoplasia: a prospective colonoscopy study of 5,899 screening participants.
abstract: We evaluated the performance of seven existing risk scoring systems in predicting advanced colorectal neoplasia in an asymptomatic Chinese cohort. We prospectively recruited 5,899 Chinese subjects aged 50-70 years in a colonoscopy screening programme(2008-2014). Scoring systems under evaluation included two scoring tools from the US; one each from Spain, Germany, and Poland; the Korean Colorectal Screening(KCS) scores; and the modified Asia Pacific Colorectal Screening(APCS) scores. The c-statistics, sensitivity, specificity, positive predictive values(PPVs), and negative predictive values(NPVs) of these systems were evaluated. The resources required were estimated based on the Number Needed to Screen(NNS) and the Number Needed to Refer for colonoscopy(NNR). Advanced neoplasia was detected in 364 (6.2%) subjects. The German system referred the least proportion of subjects (11.2%) for colonoscopy, whilst the KCS scoring system referred the highest (27.4%). The c-statistics of all systems ranged from 0.56-0.65, with sensitivities ranging from 0.04-0.44 and specificities from 0.74-0.99. The modified APCS scoring system had the highest c-statistics (0.65, 95% C.I. 0.58-0.72). The NNS (12-19) and NNR (5-10) were similar among the scoring systems. The existing scoring systems have variable capability to predict advanced neoplasia among asymptomatic Chinese subjects, and further external validation should be performed.
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.|School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, 4/F, School of Public Health Building, Prince of Wales Hospital, Shatin, NT, Hong Kong, HKSAR, China.
authors.forename: Martin C S
authors.initials: MC
authors.lastname: Wong
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Jessica Y L
authors.initials: JY
authors.lastname: Ching
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Simpson
authors.initials: S
authors.lastname: Ng
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Thomas Y T
authors.initials: TY
authors.lastname: Lam
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Arthur K C
authors.initials: AK
authors.lastname: Luk
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Sunny H
authors.initials: SH
authors.lastname: Wong
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Siew C
authors.initials: SC
authors.lastname: Ng
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Simon S M
authors.initials: SS
authors.lastname: Ng
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Justin C Y
authors.initials: JC
authors.lastname: Wu
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Francis K L
authors.initials: FK
authors.lastname: Chan
authors.affiliation: Institute of Digestive Disease, Chinese University of Hong Kong, 7/F, Lui Che Woo Clinical Science Building, Prince of Wales Hospital, Shatin, NT, HKSAR.
authors.forename: Joseph J Y
authors.initials: JJ
authors.lastname: Sung
mesh_terms: D000368:Aged; D002681:China / Q000453:epidemiology; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity
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