Prediction of the Risk of a Metachronous Advanced Colorectal Neoplasm Using a Novel Scoring System.

Lee, Ji Young; Park, Hye Won; Kim, Min-Ju; Lee, Jong-Soo; Lee, Ho-Su; Chang, Hye-Sook; Choe, Jaewon; Hwang, Sung Wook; Yang, Dong-Hoon; Myung, Seung-Jae; Yang, Suk-Kyun; Byeon, Jeong-Sik
Digestive diseases and sciences
2016Oct ; 61 ( 10 ) :3016-3025.
저자 상세정보
Lee, Ji Young -
Park, Hye Won -
Kim, Min-Ju -
Lee, Jong-Soo -
Lee, Ho-Su -
Chang, Hye-Sook -
Choe, Jaewon -
Hwang, Sung Wook -
Yang, Dong-Hoon -
Myung, Seung-Jae -
Yang, Suk-Kyun -
Byeon, Jeong-Sik -
BACKGROUND AND AIM: This study aimed to develop and validate a risk score model to estimate the probability of a metachronous advanced colorectal neoplasm (ACRN) at surveillance colonoscopy.

METHODS: A retrospective analysis of a prospectively obtained database of 11,042 asymptomatic subjects who underwent surveillance colonoscopy after a screening colonoscopy was conducted. Subjects were randomly divided into derivation (n?=?7730) and validation sets (n?=?3312). From the derivation cohort, risk factors for a metachronous ACRN were identified by a multivariable analysis. Risk points were allocated to each risk factor based on the hazard ratio to develop the Metachronous Advanced colorectal neoplasm Prediction Scoring (MAPS) model, the performance of which was assessed in the validation cohort.

RESULTS: In the derivation cohort, age, male, sessile serrated adenoma/polyp, and a high-risk CRN (ACRN or ?? adenomas) at screening colonoscopy were independent risk factors for a metachronous ACRN. These variables were incorporated into the MAPS model, and the risk score ranged 0-17 (high MAPS risk arbitrarily defined as 10-17). At the 3-year surveillance colonoscopy, ACRN was found in 5.1?% of the high MAPS risk group versus 3.9?% of the high-risk CRN group. The colonoscopy number needed to detect one metachronous ACRN at the 3-year surveillance was 19.5 (95?% CI 11.7-33.2) for the high MAPS risk group versus 25.8 (95?% CI 15.4-44.0) for the high-risk CRN group. These findings were similarly confirmed in the validation cohort.

CONCLUSIONS: Our MAPS model based on clinical and colonoscopic parameters effectively predicts the risk of a metachronous ACRN.
Colorectal neoplasm Metachronous Colonoscopy Surveillance
Adenoma/*epidemiology/pathology, Adult, Age Factors, Aged, Carcinoma/*epidemiology/pathology, Colonic Polyps/*epidemiology/pathology, Colonoscopy, Colorectal Neoplasms/*epidemiology/pathology, Early Detection of Cancer, Female, Humans, Male, Middle Aged, Multivariate Analysis, Neoplasms, Second Primary/*epidemiology/pathology, Proportional Hazards Models, Retrospective Studies, Risk Factors, Sex Factors

주제명(Target field)
연구참여(Sample size)
질병특성(Condition Category)
연구설계(Study Design)
중재방법(Intervention Type)
중재명칭(Intervention Name)
At the 3-year surveillance colonoscopy, ACRN was found in 5.1 % of the high MAPS risk group versus 3.9 % of the high-risk CRN group.
연구비지원(Fund Source)
근거수준평가(Evidence Hierarchy)
ICD 03