Premium
Capability of four sigmoidoscopy‐based screening strategies to predict proximal neoplasia in an asymptomatic Chinese population
Author(s) -
Chen Ping,
Huang Jason Liwen,
Yuan Xiaoqin,
Huang Junjie,
Wang Harry Haoxiang,
Tse Gary,
Wong Martin C S,
Wu Yunlin
Publication year - 2019
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14374
Subject(s) - medicine , sigmoidoscopy , asymptomatic , colonoscopy , colorectal cancer , receiver operating characteristic , chinese population , gastroenterology , rectum , population , cancer , gynecology , genotype , biochemistry , chemistry , environmental health , gene
Background and Aim A proper colonoscopy referral criterion is essential for flexible sigmoidoscopy‐based colorectal cancer screening. We aimed to compare the predictive capability of four existing criteria to detect proximal neoplasia (PN) and advanced proximal neoplasia (APN) in a Chinese population. Methods Asymptomatic Chinese participants aged 50–75 years, who received screening colonoscopy, were consecutively recruited. The four criteria included (i) UK flexible sigmoidoscopy; (ii) Italian Screening for COlon REctum; (iii) NORwegian Colorectal Cancer Prevention trial; and (iv) US clinical index. The sensitivity, specificity, positive/negative predictive value, and the number of subjects needed to screen (NNS)/refer (NNR) to detect one APN/PN were examined. The area under receiver operating characteristic curve was evaluated. Results Among 5833 subjects, 749 (12.8%) and 151 (2.6%) cases were found to have PN and APN, respectively. US criteria achieved the highest sensitivity for PN (49%) and APN (66%), while UK criteria attained the highest specificity (93%) for PN/APN. The lowest NNS was required by US criteria for PN (16 vs 19–38) and APN (58 vs 69–86), while the lowest NNR was required by UK criteria for PN (3.2 vs 4.0–4.8) and APN (7 vs 10–16). The receiver operating characteristic of all four criteria was 0.57–0.61 for PN and 0.68–0.70 for APN. Conclusions Among all the four criteria, US criteria had the highest sensitivity and lowest NNS, while UK criteria achieved the highest specificity and lowest NNR. Their limited discriminatory capability highlighted the need for a new score to predict PN/APN in Chinese populations.