Simple Prediction Model for Colorectal Serrated Polyps: Development and External Validation Study in U.S. Prospective
Zhangyan Lyu1,2,3, Dong Hang2,4, Xiaosheng He5,6,7
1Department of Epidemiology and Biostatistics, Tianjin Medical University Cancer Institute and Hospital, Tianjin, P.R. China.
Cancer Prevention Research (Philadelphia, Pa.)
|March 1, 2023
Summary
A new prediction model identifies high-risk serrated polyps (SPs) using five key factors. This tool aids in personalized colorectal cancer screening and lifestyle advice.
Area of Science:
- Gastroenterology and Oncology
- Preventive Medicine
- Epidemiology
Background:
- Serrated polyps (SPs) are significant precursors to colorectal cancer (CRC).
- SPs disproportionately contribute to postcolonoscopy CRC cases.
- Accurate risk prediction is crucial for early detection and prevention.
Purpose of the Study:
- To develop and validate a prediction model for high-risk serrated polyps (SPs).
- To assess the model's utility in identifying individuals needing tailored CRC screening.
- To evaluate the model's potential for informing healthy lifestyle recommendations.
Main Methods:
- Development of prediction models using three large U.S. cohorts (over 43,000 women and 5,000 men).
- External validation of the model in the Partners Colonoscopy Cohort (over 51,000 women and 39,000 men).
- Evaluation of model performance using C-statistics for discrimination and Hosmer-Lemeshow tests for calibration.
Main Results:
- A simple model including age, family history, smoking, alcohol, and BMI demonstrated good predictive accuracy (C-statistic 0.68 in women, 0.68 in men).
- The model showed moderate discrimination in the validation cohort (C-statistic 0.60 for both sexes).
- Adequate calibration was observed, and the model also predicted a composite endpoint of SPs and high-risk adenomas.
Conclusions:
- A simple, externally validated prediction model for high-risk serrated polyps was developed.
- The model, based on five major risk factors, shows potential for personalized CRC screening strategies.
- Findings support the use of this model for guiding healthy lifestyle recommendations and tailored prevention efforts.
