ArticleBMC cancer2019
Prediction of advanced colonic neoplasm in symptomatic patients: a scoring system to prioritize colonoscopy (COLONOFIT study).
Article in BMC cancer, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Article
- Review
- A self-reported symptom-based decision-making model helps to rule out outpatient cases at low risk for CRC before colonoscopy.Heliyon · 2024Article
- The performance of FIT-based and other risk prediction models for colorectal neoplasia in symptomatic patients: a systematic review.EClinicalMedicine · 2023Review
- Fecal occult blood and calprotectin testing to prioritize primary care patients for colonoscopy referral: The advantage study.United European gastroenterology journal · 2023Article
- Double faecal immunochemical testing in patients with symptoms suspicious of colorectal cancer.The British journal of surgery · 2023Article
- Article
- Interval colonoscopy following acute diverticulitis should not be discouraged yet: results from a retrospective cohort.Surgical endoscopy · 2021Article
- Faecal immunochemical test outside colorectal cancer screening?World journal of gastroenterology · 2021Review
- Appraisal of the faecal haemoglobin, age and sex test (FAST) score in assessment of patients with lower bowel symptoms: an observational study.BMC gastroenterology · 2019Observational
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Authors and funding
13 authors.
Funding
Abstract
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 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.
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 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.
conclusionsA scoring system was derived and validated to prioritize fast-track colonoscopies according to risk, which was efficient, simple, and robust.
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