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Original Articles
- The classification capability of the Asia Pacific Colorectal Screening score in Korea: an analysis of the Cancer Screenee Cohort
- Xuan Quy Luu, Kyeongmin Lee, Jeongseon Kim, Dae Kyung Sohn, Aesun Shin, Kui Son Choi
- Epidemiol Health. 2021;43:e2021069. Published online September 16, 2021
- DOI: https://doi.org/10.4178/epih.e2021069
- 26,335 View
- 248 Download
- 10 Web of Science
- 13 Crossref
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Abstract
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AbstractOBJECTIVES
This study aimed to validate a simple risk assessment tool for estimating the advanced colorectal neoplasia (ACN) risk at colonoscopy screenings and potential factors relevant for implementing this tool in the Korean population.METHODSOur study analyzed data from the Cancer Screenee Cohort Study conducted by the National Cancer Center in Korea. The risk level was assessed using the Asia Pacific Colorectal Screening (APCS) score developed by the Asia-Pacific Working Group on Colorectal Cancer. Logistic regression models were used to examine the associations between colorectal-related outcomes and the risk level by APCS score. The discriminatory performance of the APCS score for various colorectal-related outcomes was assessed using C-statistics.RESULTSIn 12,520 individuals, 317 ACN cases and 4,528 adenoma cases were found. The APCS tool successfully classified the study population into different risk groups, and significant differences in the ACN rate and other outcomes were observed. The APCS score demonstrated acceptable discrimination capability with area under the curve values ranging from 0.62 to 0.65 for various outcomes. The results of the multivariate logistic regression model revealed that the high-risk group had a 3.1-fold higher risk of ACN (95% confidence interval, 2.08 to 4.67) than the average-risk group. Body mass index (BMI) was identified as a significant predictor of ACN in both multivariate and subgroup analyses.CONCLUSIONSOur study highlighted significant differences in colorectal-related screening outcomes by colorectal risk level measured using the APCS score, and BMI could be used to improve the discriminatory capability of the APCS score. -
SummaryKorean summary
검진의 위해성을 줄이면서 동시에 이득을 최대화할 수 있는 최적의 검진 프로그램은 암 발생 위험도를 고려하는 것이다. 이 연구는 Asia-Pacific Working Group on Colorectal Cancer에서 제안한 “Asia Pacific Colorectal Screening Score (APCS)”가 한국인에서 대장암 발생 위험도를 선별적으로 잘 구분해 낼 수 있음을 보여주었다. 나아가 대장암의 위험도 점수를 산출하는데 체질량지수가 중요한 예측 변수라는 것을 확인하였고, 한국인에서 대장암 발생 위험도의 변별력을 향상시키기 위해 기존의 APCS에 체질량지수를 추가할 것을 제안하였다.Key Message
This study highlighted that the Asia Pacific Colorectal Screening Score by the Asia-Pacific Working Group on Colorectal Cancer could successfully classify Korean screenees into different risk groups with acceptable discriminatory capability. Furthermore, our study results also suggest that BMI is a significant predictor of colorectal-related health outcomes, which could be potentially added to the original APCS score for improving its discriminatory power. -
Citations
Citations to this article as recorded by
- Novel Technologies for Gastrointestinal Cancer Detection: A Systematic Review and Meta-Analysis of Diagnostic Accuracy
Melissa Barlow, Sarah Bailey, Saleh Alessy, Badr Al-Bawardy, Sadeem Aldarweesh, Rowaedh A. Bawaked, Heba Alharith, Amin Mahdi, Asrar Alaklabi, Mohammad Mawardi, Aldanah M. Althwanay, Nora A. Althumiri, Saleh Alabbad, Khalid I. Bzeizi, Severin Rakic, Ahmed
Clinical and Translational Gastroenterology.2026;[Epub] CrossRef - Development and Internal Validation of a Machine Learning-Based Colorectal Cancer Risk Prediction Model
Deborah Jael Herrera, Daiane Maria Seibert, Karen Feyen, Marlon van Loo, Guido Van Hal, Wessel van de Veerdonk
Gastrointestinal Disorders.2025; 7(2): 26. CrossRef - Advancements in the colorectal cancer screening, a Euro-Asian perspective
Nadim Hussein Malibary
Asian Journal of Surgery.2025; 48(6): 3487. CrossRef - Modified predictive model incorporating the waist-to-hip ratio for advanced colorectal neoplasia: A step toward precision screening
Zong-Xian Zhao, Zong-Ju Hu
World Journal of Clinical Oncology.2025;[Epub] CrossRef - Assessing the Feasibility and Acceptability of a Colorectal Cancer Risk Prediction Tool in Primary Care to Increase Screening Uptake in Singapore: A Multi-Methods Pilot Study
Rose Wai-Yee Fok, Sze Wern Lim, Dhana Letchimy, Jianbang Chiang, Jeanette Yuen, Tiffany Qing Lim, Zi Yang Chua, Shun Zi Liong, Grace Meijuan Yang, Ngiap Chuan Tan, Eng Sing Lee, Joanne Ngeow
Journal of Primary Care & Community Health.2025;[Epub] CrossRef - Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review
Mai Ngoc Luu, Nhi Ai Trinh, Truc Le Thanh Tran, Thinh Phuong Dang, Toru Hiyama, Duc Trong Quach
Journal of Gastroenterology and Hepatology.2024; 39(6): 1000. CrossRef - Developing a Nomogram for Predicting Colorectal Cancer and Its Precancerous Lesions Based on Data from Three Non-Invasive Screening Tools, APCS, FIT, and sDNA
Yuan Ze, Hui-Ming Tu, Yuan-Yuan Zhao, Lin Zhang
Journal of Multidisciplinary Healthcare.2024; Volume 17: 2891. CrossRef - Predicting the risk of colorectal cancer among diabetes patients using a random survival forest-guided approach
Sarah Tsz Yui Yau, Chi Tim Hung, Eman Yee Man Leung, Ka Chun Chong, Albert Lee, Eng Kiong Yeoh
Frontiers in Oncology.2024;[Epub] CrossRef - A Comparison of Single and Combined Schemes of Asia-Pacific Colorectal Screening, Faecal Immunochemical and Stool Deoxyribonucleic Acid Testing for Community Colorectal Cancer Screening
Yuan Ze, Huiming Tu, Lin Zhang, Yu Bai, Yilin Ren, Xin Chen, Yuzheng Xue, Renjuan Sun, Yuling Yang, Jie Yang, Xuan Zhou, Li Liu
Journal of Multidisciplinary Healthcare.2023; Volume 16: 571. CrossRef - Advances in Screening Methods for Colorectal Cancer
碗宜 张
Advances in Clinical Medicine.2023; 13(03): 2995. CrossRef - From Algorithms to Clinical Utility: A Systematic Review of Individualized Risk Prediction Models for Colorectal Cancer
Deborah Jael Herrera, Wessel van de Veerdonk, Daiane Maria Seibert, Moges Muluneh Boke, Claudia Gutiérrez-Ortiz, Nigus Bililign Yimer, Karen Feyen, Allegra Ferrari, Guido Van Hal
Gastrointestinal Disorders.2023; 5(4): 549. CrossRef - Socioeconomic inequality in organized and opportunistic screening for colorectal cancer: results from the Korean National Cancer Screening Survey, 2009-2021
Xuan Quy Luu, Kyeongmin Lee, Jae Kwan Jun, Mina Suh, Kui Son Choi
Epidemiology and Health.2023; 45: e2023086. CrossRef - A scoping review of risk-stratified bowel screening: current evidence, future directions
J. M. Cairns, S. Greenley, O. Bamidele, D. Weller
Cancer Causes & Control.2022; 33(5): 653. CrossRef
- Novel Technologies for Gastrointestinal Cancer Detection: A Systematic Review and Meta-Analysis of Diagnostic Accuracy
- A Case-Control Study on dietary Factors of Colorectal Adenomatous Polyps by Sites.
- Mi Kyung Kim, Won Chul Lee, Kyu Yong Choi, Su Kil Kim, Se Young Lee, Yang Cha Lee-Kim, Kwang Ho Meng
- Korean J Epidemiol. 1998;20(1):154-166.
- 10,008 View
- 18 Download
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AbstractColorectal adenomas are benign neoplasm in the large bowel that are thought to be precursors lesion to colorectal cancer. So, studying adenomatous polyps instead of cancer might allow one to measure the diet of relatively asymptomatic subjects closer to the time of the initial neoplastic process. Some dietary factor, or set of factors, apparently plays an impotant role in the etiology of colorectal adenomatous polyps. The difference of the possible association of colorectal adenomatous polyps with dietary risk factors by anatomic subsite and gender was investigated in this case-control study. Between July 1994 and April 1998, 314 cases of patients with pathologically confirmed incident colorectal adenomatous polyps and 88 control subjects were collected from Our Lady of Mercy Hospital, The Catholic University. After colonoscopy, infor-mation on exposure was obtained by the interviewers. Also, subjects were interviewed using the semiquantitative food frequency questionnaire, and average daily nutrient intakes were calculated. Site- and gender-specific odds ratio relative to the lowest tertile of intake for each nutrient were determined using unconditional logistic regression after adjusting for a number of potential confounders. In females, significant odds ratio were found for b-carotene(0.31, 95% CI, 0.10~0.95), vitamin C(0.11, 95% CI, 0.02~0.61), vitamin-E(0.11, 95% CI, 0.02~0.78) in right colon but only the odds ratio of vitamin E(0.17, 95% CI, 0.03~0.90) was statistically significant in left colon. Among food groups, the odds ratio of green yellow vegetables was significant(OR=0.21, 95% CI, 0.05~0.96) in right colon. In males, almost all the above dietary factors were statistically not significant. In males, cigarette smoking appears to be a signigicant risk factor(OR=8.86, 95% CI, 1.10~71.5) in left colon, it was statistically not signigicant(OR=1.63, 95% CI, 0.42~4.76) in the right colon. Findings fron this study show that many associations of the nutrients with colorectal adenomatous polyps risk are different by anatomic subsite and gender and support the hypothesis that high intake of antioxidant vitamins and green yellow vagetables decreases the risk of polyps.
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