Publication Date
10-7-2020
Journal
World Journal of Gastrointestinal Endoscopy
DOI
10.3748/wjg.v26.i37.5705
PMID
33088163
PMCID
PMC7545395
PubMedCentral® Posted Date
10-7-2020
PubMedCentral® Full Text Version
Post-Print
Published Open-Access
no
Keywords
Adenoma, Adult, Colonoscopy, Colorectal Neoplasms, Early Detection of Cancer, Humans, Mass Screening, Prospective Studies, Risk Factors, Colon, Adenoma, Cancer, Risk factors
Abstract
BACKGROUND: In resource-limited countries, risk stratification can be used to optimize colorectal cancer screening. Few prospective risk prediction models exist for advanced neoplasia (AN) in true average-risk individuals.
AIM: To create and internally validate a risk prediction model for detection of AN in average-risk individuals.
METHODS: Prospective study of asymptomatic individuals undergoing first screening colonoscopy. Detailed characteristics including diet, exercise and medications were collected. Multivariate logistic regression was used to elucidate risk factors for AN (adenoma ≥1 cm, villous histology, high-grade dysplasia or carcinoma). The model was validated through bootstrapping, and discrimination and calibration of the model were assessed.
RESULTS: 980 consecutive individuals (51% F; 49% M) were enrolled. Adenoma and AN detection rates were 36.6% (F 29%: M 45%;
CONCLUSION: The prevalence of adenoma and AN in average-risk Lebanese individuals is similar to the West. Age, smoking, and BMI are important predictors of AN, with obesity being particularly powerful. Though external validation is needed, this model provides an important platform for improved risk-stratification for screening programs in regions where universal screening is not currently employed.
Included in
Digestive System Diseases Commons, Gastroenterology Commons, Medical Sciences Commons, Neoplasms Commons, Oncology Commons
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