IDDF2022-ABS-0156 Risk score for advanced colorectal neoplasia in symptomatic individuals: a derivation and validation study. (2nd September 2022)

• Record Type: Journal Article
• Authors: Huang, Junjie; Leung, Eman; Wang, Harry; Wong, Martin
• Is Part Of: Gut. Volume 71(2022)Supplement 2
• Page Start: A10
• Page End: A10
• Publication Date: 2022-09-02
• Subjects: Gastroenterology -- Periodicals; 616.33
• DOI: 10.1136/gutjnl-2022-IDDF.11
• Languages: English
• ISSNs: 0017-5749

Abstract

Abstract : Background: Colorectal cancer contributes to a substantial proportion of the cancer burden. We aim to devise and validate a risk score for advanced colorectal neoplasia in a large cohort. Methods: We recruited symptomatic patients aged ≥40 years and received colonoscopy from 1997 to 2017. A multivariable regression analysis of all variables that predict advanced colorectal neoplasia with statistical significance (p < 0.05) in the univariable analysis was performed to obtain adjusted OR (aOR). The algorithm's discriminatory ability was evaluated as the area under the curve of the mathematically constructed receiver operating characteristic curve. Results: A total of 495, 584 participants were included in the study. Age (aOR=1.543–7.375), male gender (aOR=1.513), inpatient setting (aOR =1.751), abnormal aspartate transaminase/alanine transaminase (aOR=1.065), white blood cell (aOR=1.064), plasma gamma-glutamyl transferase (aOR=1.110), high-density lipoprotein cholesterol (aOR=11.699), triglycerides (aOR=1.240), and Haemoglobin A1c (aOR=1.296) were significantly associated with advanced colorectal neoplasia. A score of <2.65 was designated as low risk. Scores at 2.65 or above had a prevalence higher than the average and hence were assigned as high risk. The prevalence of advanced colorectal neoplasia was 32% and 11%, respectively for high-risk and low-risk groups. The number needed for screening was 3, highlighting the efficiency of the scores to detect one advanced colorectal neoplasia. The area under the curve for the risk score in the derivation and validation cohort was 70.12%. Conclusions: This study has validated a simple, accurate and easy-to-use risk score which has a high discriminatory capability to predict advanced colorectal neoplasia in symptomatic patients.