Risk of advanced neoplasia using the national cancer institute's colorectal cancer risk assessment tool

Thomas Imperiale, Yu Menggang, Patrick Monahan, Timothy E. Stump, Rebeka Tabbey, Elizabeth Glowinski, David F. Ransohoff

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: There is no validated, discriminating, and easy-to-apply tool for estimating risk of colorectal neoplasia. We studied whether the National Cancer Institute's (NCI's) Colorectal Cancer (CRC) Risk Assessment Tool, which estimates future CRC risk, could estimate current risk for advanced colorectal neoplasia among average-risk persons. Methods: This cross-sectional study involved individuals age 50 to 80 years undergoing first-time screening colonoscopy. We measured medical and family history, lifestyle information, and physical measures and calculated each person's future CRC risk using the NCI tool's logistic regression equation. We related quintiles of future CRC risk to the current risk of advanced neoplasia (sessile serrated polyp or tubular adenoma1 cm, a polyp with villous histology or high-grade dysplasia, or CRC). All statistical tests were two-sided. Results: For 4457 (98.5%) with complete data (mean age = 57.2 years, SD=6.6 years, 51.7% women), advanced neoplasia prevalence was 8.26%. Based on quintiles of five-year estimated absolute CRC risk, current risks of advanced neoplasia were 2.1% (95% confidence interval [CI] = 1.3% to 3.3%), 4.8% (95% CI=3.5% to 6.4%), 6.4% (95% CI=4.9% to 8.2%), 10.0% (95% CI=8.1% to 12.1%), and 17.6% (95% CI=15.5% to 20.6%; P < .001). For quintiles of estimated 10-year CRC risk, corresponding current risks for advanced neoplasia were 2.2% (95% CI=1.4% to 3.5%), 4.8% (95% CI=3.5% to 6.4%), 6.5% (95% CI=5.0% to 8.3%), 9.3% (95% CI=7.5% to 11.4%), and 18.4% (95% CI=15.9% to 21.1%; P < .001). Among persons with an estimated five-year CRC risk above the median, current risk for advanced neoplasia was 12.8%, compared with 3.7% among those below the median (relative risk = 3.4, 95 CI=2.7 to 4.4). Conclusions: The NCI's Risk Assessment Tool, which estimates future CRC risk, may be used to estimate current risk for advanced neoplasia, making it potentially useful for tailoring and improving CRC screening efficiency among average-risk persons.

Original languageEnglish (US)
Article numberdjw181
JournalJournal of the National Cancer Institute
Volume109
Issue number1
DOIs
StatePublished - 2017

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National Cancer Institute (U.S.)
Colorectal Neoplasms
Confidence Intervals
Neoplasms
Polyps
Medical History Taking
Colonoscopy

ASJC Scopus subject areas

  • Medicine(all)
  • Oncology
  • Cancer Research

Cite this

Risk of advanced neoplasia using the national cancer institute's colorectal cancer risk assessment tool. / Imperiale, Thomas; Menggang, Yu; Monahan, Patrick; Stump, Timothy E.; Tabbey, Rebeka; Glowinski, Elizabeth; Ransohoff, David F.

In: Journal of the National Cancer Institute, Vol. 109, No. 1, djw181, 2017.

Research output: Contribution to journalArticle

Imperiale, Thomas ; Menggang, Yu ; Monahan, Patrick ; Stump, Timothy E. ; Tabbey, Rebeka ; Glowinski, Elizabeth ; Ransohoff, David F. / Risk of advanced neoplasia using the national cancer institute's colorectal cancer risk assessment tool. In: Journal of the National Cancer Institute. 2017 ; Vol. 109, No. 1.
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title = "Risk of advanced neoplasia using the national cancer institute's colorectal cancer risk assessment tool",
abstract = "Background: There is no validated, discriminating, and easy-to-apply tool for estimating risk of colorectal neoplasia. We studied whether the National Cancer Institute's (NCI's) Colorectal Cancer (CRC) Risk Assessment Tool, which estimates future CRC risk, could estimate current risk for advanced colorectal neoplasia among average-risk persons. Methods: This cross-sectional study involved individuals age 50 to 80 years undergoing first-time screening colonoscopy. We measured medical and family history, lifestyle information, and physical measures and calculated each person's future CRC risk using the NCI tool's logistic regression equation. We related quintiles of future CRC risk to the current risk of advanced neoplasia (sessile serrated polyp or tubular adenoma1 cm, a polyp with villous histology or high-grade dysplasia, or CRC). All statistical tests were two-sided. Results: For 4457 (98.5{\%}) with complete data (mean age = 57.2 years, SD=6.6 years, 51.7{\%} women), advanced neoplasia prevalence was 8.26{\%}. Based on quintiles of five-year estimated absolute CRC risk, current risks of advanced neoplasia were 2.1{\%} (95{\%} confidence interval [CI] = 1.3{\%} to 3.3{\%}), 4.8{\%} (95{\%} CI=3.5{\%} to 6.4{\%}), 6.4{\%} (95{\%} CI=4.9{\%} to 8.2{\%}), 10.0{\%} (95{\%} CI=8.1{\%} to 12.1{\%}), and 17.6{\%} (95{\%} CI=15.5{\%} to 20.6{\%}; P < .001). For quintiles of estimated 10-year CRC risk, corresponding current risks for advanced neoplasia were 2.2{\%} (95{\%} CI=1.4{\%} to 3.5{\%}), 4.8{\%} (95{\%} CI=3.5{\%} to 6.4{\%}), 6.5{\%} (95{\%} CI=5.0{\%} to 8.3{\%}), 9.3{\%} (95{\%} CI=7.5{\%} to 11.4{\%}), and 18.4{\%} (95{\%} CI=15.9{\%} to 21.1{\%}; P < .001). Among persons with an estimated five-year CRC risk above the median, current risk for advanced neoplasia was 12.8{\%}, compared with 3.7{\%} among those below the median (relative risk = 3.4, 95 CI=2.7 to 4.4). Conclusions: The NCI's Risk Assessment Tool, which estimates future CRC risk, may be used to estimate current risk for advanced neoplasia, making it potentially useful for tailoring and improving CRC screening efficiency among average-risk persons.",
author = "Thomas Imperiale and Yu Menggang and Patrick Monahan and Stump, {Timothy E.} and Rebeka Tabbey and Elizabeth Glowinski and Ransohoff, {David F.}",
year = "2017",
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language = "English (US)",
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journal = "Journal of the National Cancer Institute",
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T1 - Risk of advanced neoplasia using the national cancer institute's colorectal cancer risk assessment tool

AU - Imperiale, Thomas

AU - Menggang, Yu

AU - Monahan, Patrick

AU - Stump, Timothy E.

AU - Tabbey, Rebeka

AU - Glowinski, Elizabeth

AU - Ransohoff, David F.

PY - 2017

Y1 - 2017

N2 - Background: There is no validated, discriminating, and easy-to-apply tool for estimating risk of colorectal neoplasia. We studied whether the National Cancer Institute's (NCI's) Colorectal Cancer (CRC) Risk Assessment Tool, which estimates future CRC risk, could estimate current risk for advanced colorectal neoplasia among average-risk persons. Methods: This cross-sectional study involved individuals age 50 to 80 years undergoing first-time screening colonoscopy. We measured medical and family history, lifestyle information, and physical measures and calculated each person's future CRC risk using the NCI tool's logistic regression equation. We related quintiles of future CRC risk to the current risk of advanced neoplasia (sessile serrated polyp or tubular adenoma1 cm, a polyp with villous histology or high-grade dysplasia, or CRC). All statistical tests were two-sided. Results: For 4457 (98.5%) with complete data (mean age = 57.2 years, SD=6.6 years, 51.7% women), advanced neoplasia prevalence was 8.26%. Based on quintiles of five-year estimated absolute CRC risk, current risks of advanced neoplasia were 2.1% (95% confidence interval [CI] = 1.3% to 3.3%), 4.8% (95% CI=3.5% to 6.4%), 6.4% (95% CI=4.9% to 8.2%), 10.0% (95% CI=8.1% to 12.1%), and 17.6% (95% CI=15.5% to 20.6%; P < .001). For quintiles of estimated 10-year CRC risk, corresponding current risks for advanced neoplasia were 2.2% (95% CI=1.4% to 3.5%), 4.8% (95% CI=3.5% to 6.4%), 6.5% (95% CI=5.0% to 8.3%), 9.3% (95% CI=7.5% to 11.4%), and 18.4% (95% CI=15.9% to 21.1%; P < .001). Among persons with an estimated five-year CRC risk above the median, current risk for advanced neoplasia was 12.8%, compared with 3.7% among those below the median (relative risk = 3.4, 95 CI=2.7 to 4.4). Conclusions: The NCI's Risk Assessment Tool, which estimates future CRC risk, may be used to estimate current risk for advanced neoplasia, making it potentially useful for tailoring and improving CRC screening efficiency among average-risk persons.

AB - Background: There is no validated, discriminating, and easy-to-apply tool for estimating risk of colorectal neoplasia. We studied whether the National Cancer Institute's (NCI's) Colorectal Cancer (CRC) Risk Assessment Tool, which estimates future CRC risk, could estimate current risk for advanced colorectal neoplasia among average-risk persons. Methods: This cross-sectional study involved individuals age 50 to 80 years undergoing first-time screening colonoscopy. We measured medical and family history, lifestyle information, and physical measures and calculated each person's future CRC risk using the NCI tool's logistic regression equation. We related quintiles of future CRC risk to the current risk of advanced neoplasia (sessile serrated polyp or tubular adenoma1 cm, a polyp with villous histology or high-grade dysplasia, or CRC). All statistical tests were two-sided. Results: For 4457 (98.5%) with complete data (mean age = 57.2 years, SD=6.6 years, 51.7% women), advanced neoplasia prevalence was 8.26%. Based on quintiles of five-year estimated absolute CRC risk, current risks of advanced neoplasia were 2.1% (95% confidence interval [CI] = 1.3% to 3.3%), 4.8% (95% CI=3.5% to 6.4%), 6.4% (95% CI=4.9% to 8.2%), 10.0% (95% CI=8.1% to 12.1%), and 17.6% (95% CI=15.5% to 20.6%; P < .001). For quintiles of estimated 10-year CRC risk, corresponding current risks for advanced neoplasia were 2.2% (95% CI=1.4% to 3.5%), 4.8% (95% CI=3.5% to 6.4%), 6.5% (95% CI=5.0% to 8.3%), 9.3% (95% CI=7.5% to 11.4%), and 18.4% (95% CI=15.9% to 21.1%; P < .001). Among persons with an estimated five-year CRC risk above the median, current risk for advanced neoplasia was 12.8%, compared with 3.7% among those below the median (relative risk = 3.4, 95 CI=2.7 to 4.4). Conclusions: The NCI's Risk Assessment Tool, which estimates future CRC risk, may be used to estimate current risk for advanced neoplasia, making it potentially useful for tailoring and improving CRC screening efficiency among average-risk persons.

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