A Risk-Scoring System Combined With a Fecal Immunochemical Test Is Effective in Screening High-Risk Subjects for Early Colonoscopy to Detect Advanced Colorectal Neoplasms
View abstract on PubMed
Summary
This summary is machine-generated.The Asia-Pacific Colorectal Screening (APCS) scoring system effectively identifies individuals at high risk for advanced colorectal neoplasia. Combining APCS scores with fecal immunochemical tests (FIT) optimizes screening, reducing unnecessary colonoscopies.
Area Of Science
- Gastroenterology
- Oncology
- Preventive Medicine
Background
- Colorectal cancer risk factors in Asia include age, sex, smoking, and family history.
- The Asia-Pacific Colorectal Screening (APCS) scoring system was developed to identify high-risk individuals for advanced neoplasm (AN).
Purpose Of The Study
- To evaluate an algorithm combining APCS scores with fecal immunochemical test (FIT) for colorectal cancer screening.
- To assess the effectiveness of the APCS-FIT algorithm in identifying subjects with AN and reducing colonoscopy workload.
Main Methods
- A multicenter prospective study enrolled 5657 asymptomatic individuals over 40 years old across 12 Asia-Pacific regions.
- Subjects were stratified into low (LR), medium (MR), and high risk (HR) for AN based on APCS scores.
- LR and MR subjects received FIT, while HR subjects underwent colonoscopy; algorithm sensitivity for AN detection was calculated.
Main Results
- AN prevalence was 1.5% in LR, 5.1% in MR, and 10.9% in HR groups, with significantly increased AN risk in MR (3.4-fold) and HR (7.8-fold) compared to LR.
- The APCS-FIT algorithm correctly identified 70.6% of subjects with AN and 95.1% with invasive cancers for early colonoscopy.
Conclusions
- The APCS scoring system is a valuable tool for assessing colorectal cancer and advanced adenoma risk in asymptomatic individuals.
- An APCS score-based triage algorithm for FIT or colonoscopy can significantly decrease the burden on colonoscopy services.