AIM To evaluate the National Cancer Institute(NCI)Colorectal Cancer(CRC)Risk Assessment Tool as a predictor for the presence of adenomatous polyps(AP) found during screening or surveillance colonoscopy.METHODS This is...AIM To evaluate the National Cancer Institute(NCI)Colorectal Cancer(CRC)Risk Assessment Tool as a predictor for the presence of adenomatous polyps(AP) found during screening or surveillance colonoscopy.METHODS This is a retrospective single center observational study.We collected data of adenomatous polyps in each colonoscopy and then evaluated the lifetime CRC risk.We calculated the AP prevalence across risk score quintiles,odds ratios of the prevalence of AP across risk score quintiles,area under curves(AUCs)and Youden’s indexes to assess the optimal risk score cut off value for AP prevalence status.RESULTS The prevalence of AP gradually increased throughout the five risk score quintiles:i.e.,27.63%in the first and 51.35%in the fifth quintile.The odd ratios of AP prevalence in the fifth quintile compared to the first and second quintile were 2.76[confidence interval(CI):1.71-4.47]and 2.09(CI:1.32-3.30).The AUC for all patients was 0.62(CI:0.58-0.66).Youden’s Index indicated the optimal risk score cutoff value discriminating AP prevalence status was 3.60.CONCLUSION Patients with the higher NCI risk score have higher risk of AP and subsequent CRC;therefore,measures to increase the effectiveness of CRC detection in these patients include longer withdrawal time,early surveillance colonoscopy,and choosing flexible colonoscopy over other CRC screening modalities.展开更多
Objective： Prognosis of colorectal cancer strongly depends on stage at diagnosis, which can be cured in most cases at an early stage. The results were supported by different screening programmes. Few data concerning ...Objective： Prognosis of colorectal cancer strongly depends on stage at diagnosis, which can be cured in most cases at an early stage. The results were supported by different screening programmes. Few data concerning analysis of different phases of Colorectal Cancer Program were reported in literature. The aim of this study is to analyze ＂step by step＂, from a longitudinal type, the Colorectal Cancer Program, active at our Institution, verifying compliance with standards of care.Methods： We compared two different populations during the same period： patients referring to our Clinical Oncology Unit coming from Regional Colorectal Cancer Screening Program and the other population that was not in any Colorectal Cancer Program.Results： Considering patients from the Regional Colorectal Cancer Screening Program（19 patients, corresponding to 24.0% of the general case study）, 3（15.8%） were deceased and 16（84.2%） were alive without evidence of the disease（NED）. Concerning patients that are not coming from Regional Colorectal Cancer Screening Program（61 patients, corresponding to 76.0% of the general case study）, 9（14.8%） were deceased, 43（70.5%） were NED, 8（13.1%） were alive with metastases and 1（1.6%） was lost during follow-up（PFU）. Conclusions： On the basis of this experience, we concluded for high-quality care for both populations. Any critical point should be carefully analyzed in order to implement quality of care.展开更多
文摘AIM To evaluate the National Cancer Institute(NCI)Colorectal Cancer(CRC)Risk Assessment Tool as a predictor for the presence of adenomatous polyps(AP) found during screening or surveillance colonoscopy.METHODS This is a retrospective single center observational study.We collected data of adenomatous polyps in each colonoscopy and then evaluated the lifetime CRC risk.We calculated the AP prevalence across risk score quintiles,odds ratios of the prevalence of AP across risk score quintiles,area under curves(AUCs)and Youden’s indexes to assess the optimal risk score cut off value for AP prevalence status.RESULTS The prevalence of AP gradually increased throughout the five risk score quintiles:i.e.,27.63%in the first and 51.35%in the fifth quintile.The odd ratios of AP prevalence in the fifth quintile compared to the first and second quintile were 2.76[confidence interval(CI):1.71-4.47]and 2.09(CI:1.32-3.30).The AUC for all patients was 0.62(CI:0.58-0.66).Youden’s Index indicated the optimal risk score cutoff value discriminating AP prevalence status was 3.60.CONCLUSION Patients with the higher NCI risk score have higher risk of AP and subsequent CRC;therefore,measures to increase the effectiveness of CRC detection in these patients include longer withdrawal time,early surveillance colonoscopy,and choosing flexible colonoscopy over other CRC screening modalities.
文摘Objective： Prognosis of colorectal cancer strongly depends on stage at diagnosis, which can be cured in most cases at an early stage. The results were supported by different screening programmes. Few data concerning analysis of different phases of Colorectal Cancer Program were reported in literature. The aim of this study is to analyze ＂step by step＂, from a longitudinal type, the Colorectal Cancer Program, active at our Institution, verifying compliance with standards of care.Methods： We compared two different populations during the same period： patients referring to our Clinical Oncology Unit coming from Regional Colorectal Cancer Screening Program and the other population that was not in any Colorectal Cancer Program.Results： Considering patients from the Regional Colorectal Cancer Screening Program（19 patients, corresponding to 24.0% of the general case study）, 3（15.8%） were deceased and 16（84.2%） were alive without evidence of the disease（NED）. Concerning patients that are not coming from Regional Colorectal Cancer Screening Program（61 patients, corresponding to 76.0% of the general case study）, 9（14.8%） were deceased, 43（70.5%） were NED, 8（13.1%） were alive with metastases and 1（1.6%） was lost during follow-up（PFU）. Conclusions： On the basis of this experience, we concluded for high-quality care for both populations. Any critical point should be carefully analyzed in order to implement quality of care.
