Evaluation of a risk index for advanced proximal neoplasia of the colon

Gastrointestinal Endoscopy
Arlinda RucoLinda Rabeneck

Abstract

A clinical risk index that uses distal colorectal findings at flexible sigmoidoscopy (FS) in conjunction with easily determined risk factors for advanced proximal neoplasia (APN) may be useful for tailoring or prioritizing screening with colonoscopy. To conduct an external evaluation of a previously published risk index in a large, well-characterized cohort. Cross-sectional. Teaching hospital and colorectal cancer screening center. A total of 5139 asymptomatic persons aged 50 to 74 (54.9% women) with a mean age (±SD) of 58.3 (±6.2) years. Between 2003 and 2011, all participants underwent a complete screening colonoscopy and removal of all polyps. Participants were classified as low, intermediate, or high risk for APN, based on their composite risk index scores. The concordance or c-statistic was used to measure discriminating ability of the risk index. A total of 167 persons (3.2%) had APN. The prevalence of those with APN among low-, intermediate-, and high-risk categories was 2.1%, 2.9%, and 6.5%, respectively. High-risk individuals were 3.2 times more likely to have APN compared with those in the low-risk category. The index did not discriminate well between those in the low- and intermediate-risk categories. The c-statistic...Continue Reading

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Citations

Aug 9, 2015·Revista de gastroenterología de México·V Parra-PérezC F Gutiérrez de Aranguren
May 31, 2017·The American Journal of Gastroenterology·Jason L W HuangMartin C S Wong
Feb 6, 2017·Internal and Emergency Medicine·Cristina ZaccaroDino Vaira
Jan 11, 2020·Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association·Martin C S WongJoseph J Y Sung

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