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Derivation and validation of a prediction rule for estimating advanced colorectal neoplasm risk in average-risk chinese(Open Access)

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机构： [a]Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China [b]Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China [c]Department of General Surgery, Changhai Hospital, Second Military Medical University, Shanghai, China [d]Department of Radiology, Changhai Hospital, Second Military Medical University, Shanghai, China [e]Department of Gastroenterology, Second Affiliated Hospital, Hebei Medical University, Shijiazhuang, China [f]Center for Endoscope, People's Hospital of Shanxi Province, Taiyuan, China [g]Institute of Digestive Disease, Fujian Provincial Hospital, Fuzhou, China [h]Department of Gastroenterology, People's Hospital of he'Nan Province, Zhengzhou, China [i]Center for Endoscope, Zhongshan Hospital, Fudan University, Shanghai, China [j]Center for Endoscope, General Hospital of ji'Nan Military Area, Ji'nan, China [k]Shanghai Sixth People's Hospital, Shanghai Jiaotong University, Shanghai, China [l]First People's Hospital of Yunnan Province, Kunming, China [m]Department of Gastroenterology, Renji Hospital, Shanghai Jiaotong University, Shanghai, China [n]Department of Gastroenterology, First Affiliated Hospital, Nanchang University, Nanchang, China [o]Department of Gastroenterology, Shanghai Tenth People's Hospital, Shanghai, China [p]Department of Gastroenterology, First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou, China [q]Center for Endoscope, General Hospital of Shenyang Military Area, Shenyang, China [r]Department of Gastroenterology, Qilu Hospital, Shandong University, Ji'nan, China [s]Department of Gastroenterology, First Affiliated Hospital, Anhui Medical University, Hefei, China [t]Center for Endoscope, Shanghai Huadong Hospital, Shanghai, China [u]Department of Gastroenterology, First Affiliated Hospital, Ningxia Medical College, Yinchuan, China [v]Department of General Surgery, 117th Hospital of Chinese People's Liberation Army, Hangzhou, China

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关键词： colonoscopy colorectal neoplasms cross-sectional studies logistic models mass screening risk factors

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No prediction rule is currently available for advanced colorectal neoplasms, defined as invasive cancer, an adenoma of 10 mm or more, a villous adenoma, or an adenoma with high-grade dysplasia, in average-risk Chinese. In this study between 2006 and 2008, a total of 7,541 average-risk Chinese persons aged 40 years or older who had complete colonoscopy were included. The derivation and validation cohorts consisted of 5,229 and 2,312 persons, respectively. A prediction rule was developed from a logistic regression model and then internally and externally validated. The prediction rule comprised 8 variables (age, sex, smoking, diabetes mellitus, green vegetables, pickled food, fried food, and white meat), with scores ranging from 0 to 14. Among the participants with low-risk (≤3) or high-risk (>3) scores in the validation cohort, the risks of advanced neoplasms were 2.6% and 10.0% (P < 0.001), respectively. If colonoscopy was used only for persons with high risk, 80.3% of persons with advanced neoplasms would be detected while the number of colonoscopies would be reduced by 49.2%. The prediction rule had good discrimination (area under the receiver operating characteristic curve = 0.74, 95% confidence interval: 0.70, 0.78) and calibration (P = 0.77) and, thus, provides accurate risk stratification for advanced neoplasms in average-risk Chinese. © 2012 The Author.

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出版当年[2012]版：

大类 | 2 区

医学

小类 | 1 区公共卫生、环境卫生与职业卫生

最新[2023]版：

大类 | 2 区医学

小类 | 2 区公共卫生、环境卫生与职业卫生

第一作者：

第一作者机构： [a]Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China [b]Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China

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通讯机构： [a]Center for Clinical Epidemiology and Evidence-based Medicine, Second Military Medical University, Shanghai, China [b]Department of Gastroenterology, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai 200433, China

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Derivation and validation of a prediction rule for estimating advanced colorectal neoplasm risk in average-risk chinese(Open Access)

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