Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong School of Public Health and Primary Care, Chinese University of Hong Kong, Shatin, Hong Kong.
Institute of Digestive Disease, Chinese University of Hong Kong, Shatin, Hong Kong.
Gut. 2014 Jul;63(7):1130-6. doi: 10.1136/gutjnl-2013-305639. Epub 2013 Sep 17.
We aim to develop and validate a clinical scoring system to predict the risks of colorectal neoplasia to better inform screening participants and facilitate their screening test choice.
We recruited 5220 Chinese asymptomatic screening participants who underwent colonoscopy in Hong Kong during 2008-2012. From random sampling of 2000 participants, independent risk factors were evaluated for colorectal neoplasia, defined as adenoma, advanced neoplasia, colorectal cancer or any combination thereof using binary regression analysis. The ORs for significant risk factors were used to develop a scoring system ranging from 0 to 6: 0-2 'average risk' (AR) and 3-6 'high risk' (HR). The other 3220 screening participants prospectively enrolled between 2008 and 2012 for screening colonoscopy formed an independent validation cohort. The performance of the scoring system for predicting colorectal neoplasia was evaluated.
The prevalence of colorectal neoplasia in the derivation and validation cohorts was 31.4% and 30.8%, respectively. Using the scoring system developed, 78.9% and 21.1% in the validation cohort were classified as AR and HR, respectively. The prevalence of colorectal neoplasia in the AR and HR groups was 27.1% and 44.6%, respectively. The subjects in the HR group had 1.65-fold (95% CI 1.49 to 1.83) increased prevalence of colorectal neoplasia than the AR group.
The scoring system based on age, gender, smoking, family history, Body Mass Index and self-reported diabetes is useful in predicting the risk of colorectal neoplasia.
我们旨在开发和验证一种临床评分系统，以预测结直肠肿瘤的风险，从而更好地为筛查参与者提供信息，并促进他们选择筛查检测。
我们招募了 5220 名 2008 年至 2012 年期间在香港接受结肠镜检查的无症状筛查参与者。从 2000 名参与者中随机抽样，使用二元回归分析评估结直肠肿瘤的独立危险因素，定义为腺瘤、高级别肿瘤、结直肠癌或任何组合。使用显著危险因素的 OR 开发了一个评分系统，范围从 0 到 6：0-2 为“平均风险”（AR），3-6 为“高风险”（HR）。另外 3220 名于 2008 年至 2012 年期间前瞻性入组进行筛查结肠镜检查的筛查参与者形成了一个独立的验证队列。评估了评分系统预测结直肠肿瘤的性能。
在推导和验证队列中，结直肠肿瘤的患病率分别为 31.4%和 30.8%。使用开发的评分系统，验证队列中有 78.9%和 21.1%分别归类为 AR 和 HR。AR 和 HR 组的结直肠肿瘤患病率分别为 27.1%和 44.6%。HR 组的结直肠肿瘤患病率比 AR 组高 1.65 倍（95%CI 1.49 至 1.83）。
基于年龄、性别、吸烟、家族史、体重指数和自我报告的糖尿病的评分系统可用于预测结直肠肿瘤的风险。
