ArticleWorld journal of gastroenterology2025
Serum homocysteine-based traffic light triage colonoscopy screening in colorectal cancer at-risk patients: A prospective cohort study.
Article in World journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundElevated plasma homocysteine (Hcy) levels are associated with increased risk of colorectal cancer (CRC), particularly in patients with systemic inflammation or chronic conditions.
aimTo evaluate serum Hcy levels as a predictive marker of lesion risk and CRC to prioritize patients undergoing diagnostic colonoscopy.
methodsWe conducted a prospective cohort study of 301 fecal occult blood test-positive patients at San Agustín University Hospital in Asturias, Spain. Plasma Hcy levels were measured prior to the colonoscopy and classified into three thresholds: ≤ 12, 12-15, and > 15 μmol/L. Colonoscopy and histopathology determined the presence of low-risk, high-risk polyps or adenocarcinoma. Predictive performance of serum Hcy to detect lesions was assessed using logistic regression and diagnostic accuracy measures, including models adjusted for age and sex.
resultsMedian Hcy levels rose progressively with lesion severity, reaching 15.3 μmol/L in adenocarcinoma (
conclusionSerum Hcy is a clinically useful biomarker for identifying high-risk colorectal lesions and cancer, particularly when interpreted in combination with age and sex. This composite model improves predictive accuracy and enables a structured three-tiered triage system that supports faster colonoscopy scheduling for at-risk groups. The traffic light approach offers a low cost, scalable strategy to reduce delays and optimize resource use in CRC screening, especially in public health systems with limited endoscopic capacity.
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