We aimed to develop a combination screening strategy for advanced colorectal neoplasia based on the Asia-Pacific Colorectal Screening score and fecal immunochemical test results.
We reviewed the records of participants who had undergone a colonoscopy and fecal immunochemical test as part of a comprehensive health screening program. The prevalence of advanced colorectal neoplasia in participants 40–49 years old was analyzed according to Asia-Pacific Colorectal Screening scores and fecal immunochemical test results.
We analyzed the data of 9205 participants 40–49 years old and 3215 participants ≥50 years old. The prevalence of advanced colorectal neoplasia in participants 40–49 years old was 1.0%, 2.1%, 7.1%, and 13.4% in the “fecal immunochemical test (−) & Asia-Pacific Colorectal Screening < 2,” “fecal immunochemical test (−) & Asia-Pacific Colorectal Screening ≥ 2,” “fecal immunochemical test (+) & Asia-Pacific Colorectal Screening < 2,” and “fecal immunochemical test (+) & Asia-Pacific Colorectal Screening ≥ 2” subgroups, respectively. The prevalence of advanced colorectal neoplasia in “fecal immunochemical test (+) & Asia-Pacific Colorectal Screening ≥ 2” subgroup was higher than in participants ≥50 years old with Asia-Pacific Colorectal Screening ≥ 4 (13.4% vs. 5.8%, P< 0.001).
Fecal immunochemical test-positive individuals 40–49 years old with an Asia-Pacific Colorectal Screening ≥ 2 have a higher risk of advanced colorectal neoplasia than individuals ≥50 years old with an Asia-Pacific Colorectal Screening ≥ 4.
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- American College of Gastroenterology guidelines for colorectal cancer screening 2009 [corrected].Am J Gastroenterol. 2009; 104: 739-750
- Asia Pacific consensus recommendations for colorectal cancer screening.Gut. 2008; 57: 1166-1176
- Korean guidelines for colorectal cancer screening and polyp detection.Clin Endosc. 2012; 45: 25-43
- Colorectal cancer in young adults.Dig Dis Sci. 2015; 60: 722-733
- Vital signs: colorectal cancer screening, incidence, and mortality—United States, 2002–2010.MMWR Morb Mortal Wkly Rep. 2011; 60: 884-889
- Increasing disparities in the age-related incidences of colon and rectal cancers in the United States, 1975–2010.JAMA Surg. 2015; 150: 17-22
- Colorectal carcinoma in young patients.J Surg Oncol. 1992; 51: 179-182
- Favorable influence of age on tumor characteristics of sporadic colorectal adenocarcinoma: patients 30 years of age or younger may be a distinct patient group.Dis Colon Rectum. 2003; 46: 904-910
- Extending colorectal cancer screening to persons aged 40 to 49 years with immunochemical fecal occult blood test: a prospective cohort study of 513,283 individuals.J Clin Gastroenterol. 2016;
- Metabolic syndrome and smoking may justify earlier colorectal cancer screening in men.Gastrointest Endosc. 2014; 79: 961-969
- Risk factors for colorectal neoplasia in persons aged 30 to 39 years and 40 to 49 years.Gastrointest Endosc. 2015; 81 (637–45.e7)
- The Asia-Pacific Colorectal Screening score: a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects.Gut. 2011; 60: 1236-1241
- Development and validation of a risk stratification-based screening model for predicting colorectal advanced neoplasia in Korea.J Clin Gastroenterol. 2015; 49: 41-49
- Guidelines for colonoscopy surveillance after screening and polypectomy: a consensus update by the US Multi-Society Task Force on Colorectal Cancer.Gastroenterology. 2012; 143: 844-857
- A proposal to standardize reporting units for fecal immunochemical tests for hemoglobin.J Natl Cancer Inst. 2012; 104: 810-814
- Detection of advanced neoplasia with FIT versus flexible sigmoidoscopy versus colonoscopy: more is more.Dig Dis Sci. 2015; 60: 1123-1125
- Immunochemical fecal occult blood testing is equally sensitive for proximal and distal advanced neoplasia.Am J Gastroenterol. 2012; 107: 1570-1578
- Tests and investigations for colorectal cancer screening.Clin Biochem. 2014; 47: 921-939
- Participation in colorectal cancer screening trials after first-time invitation: a systematic review.Endoscopy. 2011; 43: 1059-1086
- Financial incentives for promoting colorectal cancer screening: a randomized, comparative effectiveness trial.Am J Gastroenterol. 2016;
- A combination of clinical risk stratification and fecal immunochemical test results to prioritize colonoscopy screening in asymptomatic participants.Gastrointest Endosc. 2015; 81: 719-727
- 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.Gastroenterology. 2016; 150 (617–625.e3)
- Screening patterns in patients with a family history of colorectal cancer often do not adhere to national guidelines.Dig Dis Sci. 2013; 58: 1841-1848
- Low compliance with colonoscopic screening in first-degree relatives of patients with large adenomas.Aliment Pharmacol Ther. 2006; 24: 101-109
Published online: November 15, 2017
Accepted: November 2, 2017
Received: September 22, 2017
© 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.