title: Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages.
abstract: OBJECTIVE
  Little is known about how to include adults < 50 years in colonoscopy screening. This study aimed to derive a risk-scoring model incorporating laboratory indicators for metabolic risks to predict advanced colorectal neoplasia (ACN) in asymptomatic Korean adults both younger and older than 50 years.
  
  
  METHODS
  In this cross-sectional study, 70 812 consecutive adult recipients of a screening colonoscopy in a single health check-up center in Korea between 2003 and 2012 were enrolled. A risk score model was developed using multiple logistic regression model and internally validated.
  
  
  RESULTS
  Overall prevalence of ACN was 1.4% (956/70 812). A 15-point score model was developed to comprise age, sex, family history of colorectal cancer, smoking, body mass index, serum levels of fasting glucose, low-density lipoprotein cholesterol, and carcinoembryonic antigen. Based on the score, the validation cohort could be categorized into five risk groups (low, borderline, moderate, high, and very high) with an ACN prevalence of 0.7%, 1.3%, 2.7%, 6.6%, and 13.2%, respectively. Compared with the borderline risk group, the low-risk group showed a 50.3% reduced risk of ACN. Meanwhile, the moderate, high, and very high risk groups showed 2, 5, and 10-fold increased risk of ACN. The score showed significantly superior discriminative power than the Asian-Pacific colorectal screening score (P = 0.003).
  
  
  CONCLUSIONS
  Our scoring model based on both clinical and laboratory risk factors is useful for the prediction of ACN. This score may be used to include adults < 50 years in colonoscopy screening.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Hyo-Joon
authors.initials: HJ
authors.lastname: Yang
authors.affiliation: Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Korea.
authors.forename: Sungkyoung
authors.initials: S
authors.lastname: Choi
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Soo-Kyung
authors.initials: SK
authors.lastname: Park
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Yoon Suk
authors.initials: YS
authors.lastname: Jung
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Kyu Yong
authors.initials: KY
authors.lastname: Choi
authors.affiliation: Interdisciplinary Program in Bioinformatics, Seoul National University, Seoul, Korea.|Department of Statistics, Seoul National University, Seoul, Korea.
authors.forename: Taesung
authors.initials: T
authors.lastname: Park
authors.affiliation: Comprehensive Health Care Center, Korea Cancer Center Hospital, Seoul, Korea.
authors.forename: Ji Yeon
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine and Gastrointestinal Cancer Center, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Dong Il
authors.initials: DI
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D015331:Cohort Studies; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000453:epidemiology* / Q000517:prevention & control; D003430:Cross-Sectional Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D015233:Models, Statistical; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D055815:Young Adult
keywords: colonoscopy; colorectal neoplasms; mass screening; risk assessment; young adult