Capability of four sigmoidoscopy-based screening strategies to predict proximal neoplasia in an asymptomatic Chinese population

Chen, P., Huang, J. L., Yuan, X., Huang, J., Wang, H. H. , Tse, G., Wong, M. C.S. and Wu, Y. (2019) Capability of four sigmoidoscopy-based screening strategies to predict proximal neoplasia in an asymptomatic Chinese population. Journal of Gastroenterology and Hepatology, 34(4), pp. 707-712. (doi: 10.1111/jgh.14374) (PMID:29969515)

Abstract

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.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Wang, Professor Haoxiang
• Authors: Chen, P., Huang, J. L., Yuan, X., Huang, J., Wang, H. H., Tse, G., Wong, M. C.S., and Wu, Y.
• College/School: College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care
• Journal Name: Journal of Gastroenterology and Hepatology
• Publisher: Wiley
• ISSN: 0815-9319
• ISSN (Online): 1440-1746
• Published Online: 03 July 2018
• Copyright Holders: Copyright © 2018 Journal of Gastroenterology and Hepatology Foundation and John Wiley and Sons Australia, Ltd.
• First Published: First published in Journal of Gastroenterology and Hepatology 2018 34(4):707-712
• Publisher Policy: Reproduced in accordance with the publisher copyright policy