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

BackgroundFast-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.MethodsAll patients referre...

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Authors: Fernandez-Banares, F, Cleries, R, Boadas, J, Ribes, J, Oliva, JC, Alsius, A, Sanz, X, Martinez-Bauer, E, Galter, S, Pujals, M, Pujol, M, del Pozo, P, Campo, R
Format: article
Status:Published version
Publication Date:2019
Country:España
Institution:Institut d'Investigació i Innovació Parc Taulí (I3PT)
Repository:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
OAI Identifier:oai:i3pt.fundanetsuite.com:p3640
Online Access:https://i3pt.portalinvestigacion.com/publicaciones/3640
Access Level:Open access
Keyword:Colorectal cancer
Advanced adenoma
Faecal immunological occult haemoglobin test
Fast-track colonoscopy
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spelling Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)Fernandez-Banares, FCleries, RBoadas, JRibes, JOliva, JCAlsius, ASanz, XMartinez-Bauer, EGalter, SPujals, MPujol, Mdel Pozo, PCampo, RColorectal cancerAdvanced adenomaFaecal immunological occult haemoglobin testFast-track colonoscopyBackgroundFast-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.MethodsAll patients referred for fast-track colonoscopy were evaluated. Faecal immunological haemoglobin test (3 samples; positive>4 mu 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.Results1495 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 5years) 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.ConclusionsA scoring system was derived and validated to prioritize fast-track colonoscopies according to risk, which was efficient, simple, and robust.BMC2019info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://i3pt.portalinvestigacion.com/publicaciones/3640BMC CANCERISSN: 14712407reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulíinstname:Institut d'Investigació i Innovació Parc Taulí (I3PT)Inglésinfo:eu-repo/semantics/openAccessoai:i3pt.fundanetsuite.com:p36402026-06-21T15:30:37Z
dc.title.none.fl_str_mv Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)
title Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)
spellingShingle Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)
Fernandez-Banares, F
Colorectal cancer
Advanced adenoma
Faecal immunological occult haemoglobin test
Fast-track colonoscopy
title_short Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)
title_full Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)
title_fullStr Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)
title_full_unstemmed Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)
title_sort Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study)
dc.creator.none.fl_str_mv Fernandez-Banares, F
Cleries, R
Boadas, J
Ribes, J
Oliva, JC
Alsius, A
Sanz, X
Martinez-Bauer, E
Galter, S
Pujals, M
Pujol, M
del Pozo, P
Campo, R
author Fernandez-Banares, F
author_facet Fernandez-Banares, F
Cleries, R
Boadas, J
Ribes, J
Oliva, JC
Alsius, A
Sanz, X
Martinez-Bauer, E
Galter, S
Pujals, M
Pujol, M
del Pozo, P
Campo, R
author_role author
author2 Cleries, R
Boadas, J
Ribes, J
Oliva, JC
Alsius, A
Sanz, X
Martinez-Bauer, E
Galter, S
Pujals, M
Pujol, M
del Pozo, P
Campo, R
author2_role author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Colorectal cancer
Advanced adenoma
Faecal immunological occult haemoglobin test
Fast-track colonoscopy
topic Colorectal cancer
Advanced adenoma
Faecal immunological occult haemoglobin test
Fast-track colonoscopy
description BackgroundFast-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.MethodsAll patients referred for fast-track colonoscopy were evaluated. Faecal immunological haemoglobin test (3 samples; positive>4 mu 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.Results1495 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 5years) 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.ConclusionsA scoring system was derived and validated to prioritize fast-track colonoscopies according to risk, which was efficient, simple, and robust.
publishDate 2019
dc.date.none.fl_str_mv 2019
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://i3pt.portalinvestigacion.com/publicaciones/3640
url https://i3pt.portalinvestigacion.com/publicaciones/3640
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv BMC
publisher.none.fl_str_mv BMC
dc.source.none.fl_str_mv BMC CANCER
ISSN: 14712407
reponame:r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
instname:Institut d'Investigació i Innovació Parc Taulí (I3PT)
instname_str Institut d'Investigació i Innovació Parc Taulí (I3PT)
reponame_str r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
collection r-I3PT. Repositorio Institucional Producción Científica del Institut d'Investigació i Innovació Parc Taulí
repository.name.fl_str_mv
repository.mail.fl_str_mv
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