Prediction of the Risk of a Metachronous Advanced Colorectal Neoplasm Using a Novel Scoring System

Overview

Journal Dig Dis Sci

Specialty Gastroenterology

Date 2016 Jul 1

PMID 27358228

Citations 10

Authors

Ji Young Lee

Hye Won Park

Min-Ju Kim

Jong-Soo Lee

Ho-Su Lee

Hye-Sook Chang

Jaewon Choe

Sung Wook Hwang

Dong-Hoon Yang

Seung-Jae Myung

Suk-Kyun Yang

Jeong-Sik Byeon

Affiliations

Soon will be listed here.

Abstract

Background And Aim: This study aimed to develop and validate a risk score model to estimate the probability of a metachronous advanced colorectal neoplasm (ACRN) at surveillance colonoscopy.

Methods: A retrospective analysis of a prospectively obtained database of 11,042 asymptomatic subjects who underwent surveillance colonoscopy after a screening colonoscopy was conducted. Subjects were randomly divided into derivation (n = 7730) and validation sets (n = 3312). From the derivation cohort, risk factors for a metachronous ACRN were identified by a multivariable analysis. Risk points were allocated to each risk factor based on the hazard ratio to develop the Metachronous Advanced colorectal neoplasm Prediction Scoring (MAPS) model, the performance of which was assessed in the validation cohort.

Results: In the derivation cohort, age, male, sessile serrated adenoma/polyp, and a high-risk CRN (ACRN or ≥3 adenomas) at screening colonoscopy were independent risk factors for a metachronous ACRN. These variables were incorporated into the MAPS model, and the risk score ranged 0-17 (high MAPS risk arbitrarily defined as 10-17). At the 3-year surveillance colonoscopy, ACRN was found in 5.1 % of the high MAPS risk group versus 3.9 % of the high-risk CRN group. The colonoscopy number needed to detect one metachronous ACRN at the 3-year surveillance was 19.5 (95 % CI 11.7-33.2) for the high MAPS risk group versus 25.8 (95 % CI 15.4-44.0) for the high-risk CRN group. These findings were similarly confirmed in the validation cohort.

Conclusions: Our MAPS model based on clinical and colonoscopic parameters effectively predicts the risk of a metachronous ACRN.

Citing Articles

Risk of metachronous neoplasia in early-onset colorectal cancer: meta-analysis.

Pellino G, Fuschillo G, Gonzalez-Sarmiento R, Marti-Gallostra M, Selvaggi F, Espin-Basany E BJS Open. 2024; 8(5).

PMID: 39230922 PMC: 11373379. DOI: 10.1093/bjsopen/zrae092.

Development and External Validation of a Prediction Model for Colorectal Cancer Among Patients Awaiting Surveillance Colonoscopy Following Polypectomy.

Levin T, Jensen C, Marks A, Schlessinger D, Liu V, Udaltsova N Gastro Hep Adv. 2024; 3(5):671-683.

PMID: 39165417 PMC: 11330934. DOI: 10.1016/j.gastha.2024.03.008.

Systematic review: risk prediction models for metachronous advanced colorectal neoplasia after polypectomy.

Kang J, Levine E, Fleet A, Padilla M, Lee J, Harrison H J Gastroenterol Hepatol. 2024; 39(12):2533-2544.

PMID: 39080790 PMC: 11660205. DOI: 10.1111/jgh.16682.

Large serrated polyps indicate a greater risk of advanced metachronous colorectal neoplasia than high-grade adenomas.

Medawar E, Djinbachian R, Taghiakbari M, Khoury T, Zoughlami A, Zarandi-Nowroozi M Endosc Int Open. 2023; 11(9):E849-E858.

PMID: 37942445 PMC: 10629496. DOI: 10.1055/a-2124-9788.

AGA Clinical Practice Update on Risk Stratification for Colorectal Cancer Screening and Post-Polypectomy Surveillance: Expert Review.

Issaka R, Chan A, Gupta S Gastroenterology. 2023; 165(5):1280-1291.

PMID: 37737817 PMC: 10591903. DOI: 10.1053/j.gastro.2023.06.033.

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