Background The uptake of colonoscopy is low in individuals at risk of colorectal cancer(CRC).We constructed a riskprediction score(RPS)in a large community-based sample at high risk of CRC to enable more accurate risk...Background The uptake of colonoscopy is low in individuals at risk of colorectal cancer(CRC).We constructed a riskprediction score(RPS)in a large community-based sample at high risk of CRC to enable more accurate risk stratification and to motivate and increase the uptake rate of colonoscopy.Methods A total of 12,628 participants classified as high-risk according to positivity of immunochemical fecal occult blood tests or High-Risk Factor Questionnaire underwent colonoscopy.Logistic regression was used to derive a RPS and analysed the associations of the RPS with colorectal lesions,giving odds ratios(ORs)and 95%confidence intervals(CIs).Results Of the participants,men(OR=1.73,95%CI=1.58–1.90),older age(≥65 years;1.41,1.31–1.53),higher body mass index(≥28 kg/m^(2);1.22,1.07–1.39),ever smoking(1.47,1.31–1.65),and weekly alcohol use(1.28,1.09–1.52)were associated with a higher risk of colorectal lesions.We assigned 1 point to each of the above five risk factors and derived a RPS ranging from 0 to 5,with a higher score indicating a higher risk.Compared with a RPS of 0,a RPS of 1,2,3,and 4–5 showed a higher risk of colorectal lesions,with the OR(95%CI)being 1.50(1.37–1.63),2.34(2.12–2.59),3.58(3.13–4.10),and 3.91(3.00–5.10),respectively.The area under the receiver-operating characteristic curve of RPS in predicting colorectal lesions was 0.62.Conclusions Participants with an increase in the RPS of≥1 point had a significantly higher risk of colorectal lesions,suggesting the urgency for measuring colonoscopy in this very high-risk group.High-risk strategies incorporating RPS may be employed to achieve a higher colonoscopy-uptake rate.展开更多
基金supported by the Special Foundation for Science and Technology Basic Research Program[2019FY101103].
文摘Background The uptake of colonoscopy is low in individuals at risk of colorectal cancer(CRC).We constructed a riskprediction score(RPS)in a large community-based sample at high risk of CRC to enable more accurate risk stratification and to motivate and increase the uptake rate of colonoscopy.Methods A total of 12,628 participants classified as high-risk according to positivity of immunochemical fecal occult blood tests or High-Risk Factor Questionnaire underwent colonoscopy.Logistic regression was used to derive a RPS and analysed the associations of the RPS with colorectal lesions,giving odds ratios(ORs)and 95%confidence intervals(CIs).Results Of the participants,men(OR=1.73,95%CI=1.58–1.90),older age(≥65 years;1.41,1.31–1.53),higher body mass index(≥28 kg/m^(2);1.22,1.07–1.39),ever smoking(1.47,1.31–1.65),and weekly alcohol use(1.28,1.09–1.52)were associated with a higher risk of colorectal lesions.We assigned 1 point to each of the above five risk factors and derived a RPS ranging from 0 to 5,with a higher score indicating a higher risk.Compared with a RPS of 0,a RPS of 1,2,3,and 4–5 showed a higher risk of colorectal lesions,with the OR(95%CI)being 1.50(1.37–1.63),2.34(2.12–2.59),3.58(3.13–4.10),and 3.91(3.00–5.10),respectively.The area under the receiver-operating characteristic curve of RPS in predicting colorectal lesions was 0.62.Conclusions Participants with an increase in the RPS of≥1 point had a significantly higher risk of colorectal lesions,suggesting the urgency for measuring colonoscopy in this very high-risk group.High-risk strategies incorporating RPS may be employed to achieve a higher colonoscopy-uptake rate.
