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Original Article
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
  • 4,790 View
  • 198 Download
  • 3 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
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.
METHODS
Our 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.
RESULTS
In 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.
CONCLUSIONS
Our 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.
Summary
Korean 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  
  • 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
  • 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
Editorial
Lessons from radiation epidemiology
Won Jin Lee
Epidemiol Health. 2018;40:e2018057.   Published online November 14, 2018
DOI: https://doi.org/10.4178/epih.e2018057
  • 10,304 View
  • 138 Download
  • 1 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
Radiation epidemiology has developed as a specialized field and has unique characteristics compared to the other fields of epidemiology. Radiation exposure assessment is highly quantified and health risk assessment can yield precise risks per unit dose in each organ. At the same time, radiation epidemiology also emphasizes the uncertainty of the estimated doses and risks. More radiation epidemiologists work in radiation societies rather than those of epidemiology. This specialization deepens the research of radiation studies but also results in fragmentation from general epidemiology. In addition to continued involvement with radiation-related sciences, therefore, more efforts to communicate with the other fields of epidemiology are necessary for radiation epidemiology.
Summary
Korean summary
방사선 역학은 역학의 세부 전공분야로서 다른 역학 분야와 구별되는 특성들이 있다. 노출 및 건강영향 평가에서의 정량화된 접근방법을 비롯하여 방사선 역학의 많은 장점들은 다른 역학분야에서도 응용될 필요가 있다. 이러한 전문화는 역학 연구의 내용을 깊게 발전시키는데 큰 역할을 하고 있는 반면, 일반 역학 분야와 분열되는 단점도 있다. 따라서 기존 방사선 관련 학문들과의 지속적인 교류뿐 아니라 다른 역학분야와의 활발한 교류를 통해 방사선 역학 및 전체 역학분야를 발전시키는 것이 중요하다.
Key Message

Citations

Citations to this article as recorded by  
  • The expression profile of redox genes in human monocytes exposed in vitro to γ radiation
    Gina Manda, Cristian Postolache, Ionela Victoria Neagoe, Andreea Csolti, Elena Milanesi, Maria Dobre
    Radiation Physics and Chemistry.2020; 170: 108634.     CrossRef
Review
Road dust and its effect on human health: a literature review
Raihan K. Khan, Mark A. Strand
Epidemiol Health. 2018;40:e2018013.   Published online April 10, 2018
DOI: https://doi.org/10.4178/epih.e2018013
  • 19,765 View
  • 375 Download
  • 66 Citations
AbstractAbstract PDF
Abstract
The purpose of this study was to determine the effects of road dust on human health. A PubMed search was used to extract references that included the words “road dust” and “health” or “fugitive dust” and “health” in the title or abstract. A total of 46 references were extracted and selected for review after the primary screening of 949 articles. The respiratory system was found to be the most affected system in the human body. Lead, platinum-group elements (platinum, rhodium, and bohrium), aluminum, zinc, vanadium, and polycyclic aromatic hydrocarbons were the components of road dust that were most frequently referenced in the articles reviewed. Road dust was found to have harmful effects on the human body, especially on the respiratory system. To determine the complex mechanism of action of various components of road dust on the human body and the results thereof, the authors recommend a further meta-analysis and extensive risk-assessment research into the health impacts of dust exposure.
Summary
Korean summary
Key Message

Citations

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Perspective
An opposing view on including high school students in a latent tuberculosis infection control program in Korea
Jong-Myon Bae
Epidemiol Health. 2017;39:e2017015.   Published online March 31, 2017
DOI: https://doi.org/10.4178/epih.e2017015
  • 11,849 View
  • 194 Download
  • 5 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
The Korea Centers for Diseases Control and Prevention (KCDC) has announced a control program against latent Mycobacterium tuberculosis infection (LTBI), for a “TB-safe country” this year with the goal of a “TB-free Korea” by 2025. The program includes high school students as one target group; however, some school health teachers and parents have expressed their opposition to this. The 2015 World Health Organization guidelines do not recommend inclusion of asymptomatic high school students in LTBI control programs. Based on this guideline, the KCDC should consider excluding this population from the program.
Summary
Korean summary
질병관리본부는 결핵안심국가를 만들기 위하여 고등학교 1학년생을 포함한 잠복결핵감염 검사사업을 2017년 추진하기로 공고하였다. 그러나 2015년에 발표된 WHO 지침에 따르면 해당 대상자들은 검사대상자로 제시되어 있지않다. 근거중심의 보건정책 추진을 위해서 사업 대상 선정을 재검토할 필요가 있다.
Key Message

Citations

Citations to this article as recorded by  
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  • 결핵정책에 대하여
    찬병 박
    Public Health Affairs.2017; 1(1): 13.     CrossRef

Epidemiol Health : Epidemiology and Health