External Validation of the Screening Score to Predict Advanced Colorectal Neoplasia in the Thai Population of the Colorectal Cancer Screening Project at Chulabhorn Hospital
Kamonwan Soonklang1, Bunchorn Siripongpreeda2
Affiliation : 1 Data Management Unit, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand, 2 Faculty of Medicine and Public Health, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
Objective: The present study validated four screening score models to predict advanced colorectal neoplasia, including the Asia-
Pacific colorectal score (APCS), Korean colorectal screening score (KCS), Asia-Pacific colorectal score with body mass index (APCS+BMI), and colorectal screening scores of the Chinese population (CCS) in an asymptomatic Thai population participating in a colorectal cancer screening project.
Materials and Methods: A total of 1,404 Thai individuals participated in the Royal Charity Project of colorectal cancer screening during July 2009. The participants were asked to complete questionnaires about their risk factors of CRC. To validate a fourscreening score model, a receiver operating characteristic (ROC) curve was used. The area under the ROC curve (AuROC) was also reported with 95% confidence intervals (CIs).
Results: A total of 1,349 asymptomatic Thai subjects were asked to complete a questionnaire regarding their risk factors in the risk score model and colonoscopy results. The mean age was 56.89±4.19 years and 69.8% were females. Advanced colorectal neoplasia was found in 53 subjects (3.93%). AuROC for advanced colorectal neoplasia were as follows: APCS, 0.65; 95% CI: 0.57 to 0.74), KCS, 0.66; 95% CI: 0.57 to 0.74), APCS+BMI, 0.67; 95% CI: 0.60 to 0.75, and CCS, 0.66; 95% CI: 0.58 to 0.74). All four screening score models yielded sufficient diagnostic accuracy (AuROC, 0.6 to 0.7), which is not statistically significant (p=0.683). Although no statistical significance was found in the predict advanced colorectal neoplasia, these APCS+BMI had a higher AuROC.
Conclusion: APCS+BMI provides better screening results and is recommend for Thai people. Nonetheless, future studies should be conducted for screening score development in the asymptomatic Thai population, which has high accuracy, and to determine who are most likely to benefit from colonoscopy.
Keywords : Advanced colorectal neoplasia, Screening score, Colorectal cancer screening
