title: Validation of a risk prediction score for proximal neoplasia in colorectal cancer screening: a prospective colonoscopy study.
abstract: This study developed a clinical scoring system to predict the risks of PN among screening participants for colorectal cancer. We recruited 5,789 Chinese asymptomatic screening participants who received colonoscopy in Hong Kong (2008-2014). From random sampling of 2,000 participants, the independent risk factors were evaluated for PN using binary regression analysis. The odds ratios for significant risk factors were used to develop a scoring system, with scores stratified into 'average risk' (AR):0-2 and 'high risk' (HR):3-5. The other 3,789 subjects formed an independent validation cohort. Each participant received a score calculated based on their risk factors. The performance of the scoring system was evaluated. The proportion of PN in the derivation and validation cohorts was 12.6% and 12.9%, respectively. Based on age, gender, family history, body mass index and self-reported ischaemic heart disease, 85.0% and 15.0% in the validation cohort were classified as AR and HR, respectively. Their prevalence of PN was 12.0% and 18.1%, respectively. Participants in the HR group had 1.51-fold (95% CI = 1.24-1.84, p < 0.001) higher risk of PN than the AR group. The overall c-statistics of the prediction model was 0.71(0.02). The scoring system is useful in predicting the risk of PN to prioritize patients for colonoscopy.
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.|School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Martin C S
authors: MC
authors: Wong
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Jessica Y L
authors: JY
authors: Ching
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Victor C W
authors: VC
authors: Chan
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Raymond S Y
authors: RS
authors: Tang
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Arthur K C
authors: AK
authors: Luk
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Thomas Y T
authors: TY
authors: Lam
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Sunny S H
authors: SS
authors: Wong
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Siew C
authors: SC
authors: Ng
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Simon S M
authors: SS
authors: Ng
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Justin C Y
authors: JC
authors: Wu
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Francis K L
authors: FK
authors: Chan
authors: Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong, HKSAR, China.
authors: Joseph J Y
authors: JJ
authors: Sung
mesh_terms: D000368:Aged; D003113:Colonoscopy / Q000379:methods*; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D055088:Early Detection of Cancer; D005260:Female; D005500:Follow-Up Studies; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012372:ROC Curve; D018570:Risk Assessment; D012307:Risk Factors