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Clinical application and effectiveness analysis of modified Asia-Pacific colorectal cancer screening score combined

Lin Li1, Tianzheng Wang1, Chiyi He2

  • 1Departments of Gastroenterology, Yijishan Hospital (The First Affiliated Hospital of Wannan Medical College), Wuhu, 241001, P.R. China.

BMC Gastroenterology
|April 1, 2025
PubMed
Summary

The modified Asia-Pacific colorectal cancer screening (APCS) score combined with fecal occult blood test (FOBT) effectively screens for colorectal cancer (CRC) in asymptomatic individuals. This combination aids in identifying high-risk patients needing further colonoscopy.

Keywords:
Colorectal cancerEarly detectionScreening and diagnosisTumor

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Area of Science:

  • Gastroenterology
  • Oncology
  • Preventive Medicine

Background:

  • Colorectal cancer (CRC) screening is crucial for early detection and improved patient outcomes.
  • The Asia-Pacific colorectal cancer screening (APCS) scoring system and fecal occult blood test (FOBT) are established screening tools.
  • Optimizing screening strategies for asymptomatic populations remains an ongoing area of research.

Purpose of the Study:

  • To evaluate the efficacy of a modified APCS scoring system combined with FOBT for CRC screening.
  • To assess the combined system's value in identifying colorectal tumors within an asymptomatic population in the Wannan region.
  • To identify independent risk factors for lymph node metastasis (LNM) in stage T1 CRC patients.

Main Methods:

  • Prospective study of 513 asymptomatic individuals undergoing colonoscopy.
  • Participants received modified APCS scores and FOBT prior to colonoscopy.
  • Receiver operating characteristic (ROC) curves were used to analyze screening performance; retrospective analysis for T1 CRC risk factors.

Main Results:

  • The combined modified APCS and FOBT approach identified varying CRC detection rates across five risk groups (0% to 9.09%).
  • High-risk modified APCS scores and positive FOBT results were significant indicators for further colonoscopy.
  • Tumor morphology, differentiation, and nerve infiltration were identified as independent risk factors for LNM in T1 CRC.

Conclusions:

  • The combination of modified APCS score and FOBT demonstrates significant clinical value for preliminary colorectal tumor screening in asymptomatic individuals.
  • Careful consideration of endoscopic submucosal dissection (ESD) is recommended for T1 CRC patients with ulcerative lesions and low differentiation due to LNM risk.