Please use this identifier to cite or link to this item:
http://hdl.handle.net/2445/164264
Title: | Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study). |
Author: | Fernández-Bañares, Fernando Clèries Soler, Ramon Boadas, Jaume Ribes Puig, Josepa Oliva, Joan Carles Alsius, Antoni Sanz, Xavier Martínez-Bauer, Eva Galter, Sara Pujals, Mar Pujol, Marta Del Pozo, Patricia Campo Fernández de los Rios, Rafael |
Keywords: | Colonoscòpia Càncer colorectal Tumors Hemoglobina Colonoscopy Colorectal cancer Tumors Hemoglobin |
Issue Date: | 25-Jul-2019 |
Publisher: | BioMed Central |
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 μg 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. |
Note: | Reproducció del document publicat a: https://doi.org/10.1186/s12885-019-5926-4 |
It is part of: | BMC Cancer, 2019, vol. 19, p. 734 |
URI: | http://hdl.handle.net/2445/164264 |
Related resource: | https://doi.org/10.1186/s12885-019-5926-4 |
ISSN: | 1471-2407 |
Appears in Collections: | Articles publicats en revistes (Ciències Clíniques) Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL)) |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
695854.pdf | 861.35 kB | Adobe PDF | View/Open |
This item is licensed under a Creative Commons License