The Asia-Pacific Colorectal Screening score

A validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects

Khay Guan Yeoh, Khek Yu Ho, Han Mo Chiu, Feng Zhu, Jessica Y.L. Ching, Deng Chyang Wu, Takahisa Matsuda, Jeong Sik Byeon, SangKil Lee, Khean Lee Goh, Jose Sollano, Rungsun Rerknimitr, Rupert Leong, Kelvin Tsoi, Jaw Town Lin, Joseph J.Y. Sung

Research output: Contribution to journalArticle

140 Citations (Scopus)

Abstract

Objective: To develop and validate a clinical risk score predictive of risk for colorectal advanced neoplasia for Asia. Methods: A prospective, cross-sectional and multicentre study was carried out in tertiary hospitals in 11 Asian cities. The subjects comprise 2752 asymptomatic patients undergoing screening colonoscopy. From a development set of 860 asymptomatic subjects undergoing screening colonoscopy, multiple logistic regression was applied to identify significant risk factors for advanced colorectal neoplasia defined as invasive carcinoma or advanced adenoma. The ORs for significant risk factors were utilised to develop a risk score ranging from 0 to 7 (Asia-Pacific Colorectal Screening (APCS) score). Three tiers of risk were arbitrarily defined: 0-1 'average risk' (AR); 2-3 'moderate risk' (MR); and 4-7 'high risk' (HR). Subjects undergoing screening colonoscopy between July 2006 and December 2007 were prospectively enrolled to form an independent validation group. Each subject had a personal APCS score calculated by summing the points attributed from the presence of risk factors in the individuals. The performance of the APCS score in predicting risk of advanced neoplasia was evaluated. Results: There were 860 subjects in the derivation set and 1892 subjects in the validation set, with a baseline prevalence of advanced neoplasia of 4.5% and 3%, respectively. Applying the APCS stratification in the validation set, 559 subjects (29.5%) were in the AR tier, 966 subjects (51.1%) in the MR tier and 367 (19.4%) subjects in the HR tier. The prevalence of advanced neoplasia in the AR, MR and HR groups was 1.3, 3.2 and 5.2%, respectively. The subjects in the MR and HR tiers had 2.6-fold (95% CI 1.1 to 6.0) and 4.3-fold (95% CI 1.8 to 10.3) increased prevalence of advanced neoplasia, respectively, than those in the AR tier. Conclusions: The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.

Original languageEnglish
Pages (from-to)1236-1241
Number of pages6
JournalGut
Volume60
Issue number9
DOIs
Publication statusPublished - 2011 Sep 1

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Neoplasms
Colonoscopy
Tertiary Care Centers
Adenoma
Multicenter Studies
Cross-Sectional Studies
Logistic Models
Smoking
Carcinoma

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Yeoh, Khay Guan ; Ho, Khek Yu ; Chiu, Han Mo ; Zhu, Feng ; Ching, Jessica Y.L. ; Wu, Deng Chyang ; Matsuda, Takahisa ; Byeon, Jeong Sik ; Lee, SangKil ; Goh, Khean Lee ; Sollano, Jose ; Rerknimitr, Rungsun ; Leong, Rupert ; Tsoi, Kelvin ; Lin, Jaw Town ; Sung, Joseph J.Y. / The Asia-Pacific Colorectal Screening score : A validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects. In: Gut. 2011 ; Vol. 60, No. 9. pp. 1236-1241.
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title = "The Asia-Pacific Colorectal Screening score: A validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects",
abstract = "Objective: To develop and validate a clinical risk score predictive of risk for colorectal advanced neoplasia for Asia. Methods: A prospective, cross-sectional and multicentre study was carried out in tertiary hospitals in 11 Asian cities. The subjects comprise 2752 asymptomatic patients undergoing screening colonoscopy. From a development set of 860 asymptomatic subjects undergoing screening colonoscopy, multiple logistic regression was applied to identify significant risk factors for advanced colorectal neoplasia defined as invasive carcinoma or advanced adenoma. The ORs for significant risk factors were utilised to develop a risk score ranging from 0 to 7 (Asia-Pacific Colorectal Screening (APCS) score). Three tiers of risk were arbitrarily defined: 0-1 'average risk' (AR); 2-3 'moderate risk' (MR); and 4-7 'high risk' (HR). Subjects undergoing screening colonoscopy between July 2006 and December 2007 were prospectively enrolled to form an independent validation group. Each subject had a personal APCS score calculated by summing the points attributed from the presence of risk factors in the individuals. The performance of the APCS score in predicting risk of advanced neoplasia was evaluated. Results: There were 860 subjects in the derivation set and 1892 subjects in the validation set, with a baseline prevalence of advanced neoplasia of 4.5{\%} and 3{\%}, respectively. Applying the APCS stratification in the validation set, 559 subjects (29.5{\%}) were in the AR tier, 966 subjects (51.1{\%}) in the MR tier and 367 (19.4{\%}) subjects in the HR tier. The prevalence of advanced neoplasia in the AR, MR and HR groups was 1.3, 3.2 and 5.2{\%}, respectively. The subjects in the MR and HR tiers had 2.6-fold (95{\%} CI 1.1 to 6.0) and 4.3-fold (95{\%} CI 1.8 to 10.3) increased prevalence of advanced neoplasia, respectively, than those in the AR tier. Conclusions: The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.",
author = "Yeoh, {Khay Guan} and Ho, {Khek Yu} and Chiu, {Han Mo} and Feng Zhu and Ching, {Jessica Y.L.} and Wu, {Deng Chyang} and Takahisa Matsuda and Byeon, {Jeong Sik} and SangKil Lee and Goh, {Khean Lee} and Jose Sollano and Rungsun Rerknimitr and Rupert Leong and Kelvin Tsoi and Lin, {Jaw Town} and Sung, {Joseph J.Y.}",
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Yeoh, KG, Ho, KY, Chiu, HM, Zhu, F, Ching, JYL, Wu, DC, Matsuda, T, Byeon, JS, Lee, S, Goh, KL, Sollano, J, Rerknimitr, R, Leong, R, Tsoi, K, Lin, JT & Sung, JJY 2011, 'The Asia-Pacific Colorectal Screening score: A validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects', Gut, vol. 60, no. 9, pp. 1236-1241. https://doi.org/10.1136/gut.2010.221168

The Asia-Pacific Colorectal Screening score : A validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects. / Yeoh, Khay Guan; Ho, Khek Yu; Chiu, Han Mo; Zhu, Feng; Ching, Jessica Y.L.; Wu, Deng Chyang; Matsuda, Takahisa; Byeon, Jeong Sik; Lee, SangKil; Goh, Khean Lee; Sollano, Jose; Rerknimitr, Rungsun; Leong, Rupert; Tsoi, Kelvin; Lin, Jaw Town; Sung, Joseph J.Y.

In: Gut, Vol. 60, No. 9, 01.09.2011, p. 1236-1241.

Research output: Contribution to journalArticle

TY - JOUR

T1 - The Asia-Pacific Colorectal Screening score

T2 - A validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects

AU - Yeoh, Khay Guan

AU - Ho, Khek Yu

AU - Chiu, Han Mo

AU - Zhu, Feng

AU - Ching, Jessica Y.L.

AU - Wu, Deng Chyang

AU - Matsuda, Takahisa

AU - Byeon, Jeong Sik

AU - Lee, SangKil

AU - Goh, Khean Lee

AU - Sollano, Jose

AU - Rerknimitr, Rungsun

AU - Leong, Rupert

AU - Tsoi, Kelvin

AU - Lin, Jaw Town

AU - Sung, Joseph J.Y.

PY - 2011/9/1

Y1 - 2011/9/1

N2 - Objective: To develop and validate a clinical risk score predictive of risk for colorectal advanced neoplasia for Asia. Methods: A prospective, cross-sectional and multicentre study was carried out in tertiary hospitals in 11 Asian cities. The subjects comprise 2752 asymptomatic patients undergoing screening colonoscopy. From a development set of 860 asymptomatic subjects undergoing screening colonoscopy, multiple logistic regression was applied to identify significant risk factors for advanced colorectal neoplasia defined as invasive carcinoma or advanced adenoma. The ORs for significant risk factors were utilised to develop a risk score ranging from 0 to 7 (Asia-Pacific Colorectal Screening (APCS) score). Three tiers of risk were arbitrarily defined: 0-1 'average risk' (AR); 2-3 'moderate risk' (MR); and 4-7 'high risk' (HR). Subjects undergoing screening colonoscopy between July 2006 and December 2007 were prospectively enrolled to form an independent validation group. Each subject had a personal APCS score calculated by summing the points attributed from the presence of risk factors in the individuals. The performance of the APCS score in predicting risk of advanced neoplasia was evaluated. Results: There were 860 subjects in the derivation set and 1892 subjects in the validation set, with a baseline prevalence of advanced neoplasia of 4.5% and 3%, respectively. Applying the APCS stratification in the validation set, 559 subjects (29.5%) were in the AR tier, 966 subjects (51.1%) in the MR tier and 367 (19.4%) subjects in the HR tier. The prevalence of advanced neoplasia in the AR, MR and HR groups was 1.3, 3.2 and 5.2%, respectively. The subjects in the MR and HR tiers had 2.6-fold (95% CI 1.1 to 6.0) and 4.3-fold (95% CI 1.8 to 10.3) increased prevalence of advanced neoplasia, respectively, than those in the AR tier. Conclusions: The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.

AB - Objective: To develop and validate a clinical risk score predictive of risk for colorectal advanced neoplasia for Asia. Methods: A prospective, cross-sectional and multicentre study was carried out in tertiary hospitals in 11 Asian cities. The subjects comprise 2752 asymptomatic patients undergoing screening colonoscopy. From a development set of 860 asymptomatic subjects undergoing screening colonoscopy, multiple logistic regression was applied to identify significant risk factors for advanced colorectal neoplasia defined as invasive carcinoma or advanced adenoma. The ORs for significant risk factors were utilised to develop a risk score ranging from 0 to 7 (Asia-Pacific Colorectal Screening (APCS) score). Three tiers of risk were arbitrarily defined: 0-1 'average risk' (AR); 2-3 'moderate risk' (MR); and 4-7 'high risk' (HR). Subjects undergoing screening colonoscopy between July 2006 and December 2007 were prospectively enrolled to form an independent validation group. Each subject had a personal APCS score calculated by summing the points attributed from the presence of risk factors in the individuals. The performance of the APCS score in predicting risk of advanced neoplasia was evaluated. Results: There were 860 subjects in the derivation set and 1892 subjects in the validation set, with a baseline prevalence of advanced neoplasia of 4.5% and 3%, respectively. Applying the APCS stratification in the validation set, 559 subjects (29.5%) were in the AR tier, 966 subjects (51.1%) in the MR tier and 367 (19.4%) subjects in the HR tier. The prevalence of advanced neoplasia in the AR, MR and HR groups was 1.3, 3.2 and 5.2%, respectively. The subjects in the MR and HR tiers had 2.6-fold (95% CI 1.1 to 6.0) and 4.3-fold (95% CI 1.8 to 10.3) increased prevalence of advanced neoplasia, respectively, than those in the AR tier. Conclusions: The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.

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