Dataset Information

Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study).

ABSTRACT:

Background

Fast-track colonoscopy to detect patients with colorectal cancer based on high-risk symptoms is associated with low sensitivity and specificity. The aim was to derive a predictive score of advanced colonic neoplasia in symptomatic patients in fast-track programs.

Methods

All patients referred for fast-track colonoscopy were evaluated. Faecal immunological haemoglobin test (3 samples; positive>?4??g Hb/g), and a survey to register clinical variables of interest were performed. Colorectal cancer and advanced adenoma were considered as advanced colonic neoplasia. A sample size of 600 and 500 individuals were calculated for each phase 1 and phase 2 of the study, respectively (Phase 1, derivation and Phase 2, validation cohort). A Bayesian logistic regression analysis was used to derive a predictive score.

Results

1495 patients were included. Age (OR, 21), maximum faecal-Hb value (OR, 2.3), and number of positive samples (OR, 28) presented the highest ORs predictive of advanced colonic neoplasia. The additional significant predictive variables adjusted for age and faecal-Hb variables in Phase 1 were previous colonoscopy (last 5?years) and smoking (no, ex/active). With these variables a predictive score of advanced colonic neoplasia was derived. Applied to Phase 2, patients with a Score?>?20 had an advanced colonic neoplasia probability of 66% (colorectal cancer, 32%), while those with a Score???10, a probability of 10% (colorectal cancer, 1%). Prioritizing patients with Score?>?10, 49.4% of patients would be referred for fast-track colonoscopy, diagnosing 98.3% of colorectal cancers and 77% of advanced adenomas.

Conclusions

A scoring system was derived and validated to prioritize fast-track colonoscopies according to risk, which was efficient, simple, and robust.

SUBMITTER: Fernandez-Banares F

PROVIDER: S-EPMC6659265 | biostudies-literature | 2019 Jul

REPOSITORIES: biostudies-literature

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Publications

Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study).

Fernández-Bañares Fernando F Clèries Ramon R Boadas Jaume J Ribes Josepa J Oliva Joan Carles JC Alsius Antoni A Sanz Xavier X Martínez-Bauer Eva E Galter Sara S Pujals Mar M Pujol Marta M Del Pozo Patricia P Campo Rafel R

BMC cancer 20190725 1

<h4>Background</h4>Fast-track colonoscopy to detect patients with colorectal cancer based on high-risk symptoms is associated with low sensitivity and specificity. The aim was to derive a predictive score of advanced colonic neoplasia in symptomatic patients in fast-track programs.<h4>Methods</h4>All patients referred for fast-track colonoscopy were evaluated. Faecal immunological haemoglobin test (3 samples; positive> 4 μg Hb/g), and a survey to register clinical variables of interest were perf ...[more]

PMID: 31345180

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Dataset Information

Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study).

Background

Methods

Results

Conclusions

Publications

Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study).

Similar Datasets

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