Journal of Hematology & Oncology (Nov 2022)
FIT-based risk-stratification model effectively screens colorectal neoplasia and early-onset colorectal cancer in Chinese population: a nationwide multicenter prospective study
- Shengbing Zhao,
- Shuling Wang,
- Peng Pan,
- Tian Xia,
- Rundong Wang,
- Quancai Cai,
- Xin Chang,
- Fan Yang,
- Lun Gu,
- Zixuan He,
- Jiayi Wu,
- Qianqian Meng,
- Tongchang Wang,
- Qiwen Fang,
- Xiaomei Mou,
- Honggang Yu,
- Jinghua Zheng,
- Cheng Bai,
- Yingbin Zou,
- Dongfeng Chen,
- Xiaoping Zou,
- Xu Ren,
- Leiming Xu,
- Ping Yao,
- Guangsu Xiong,
- Xu Shu,
- Tong Dang,
- Li Zhang,
- Wen Wang,
- Shengchao Kang,
- Hongfei Cao,
- Aixia Gong,
- Jun Li,
- Heng Zhang,
- Yiqi Du,
- Zhaoshen Li,
- Yu Bai,
- Gastrointestinal Early Cancer Prevention & Treatment Alliance of China (GECA)
Affiliations
- Shengbing Zhao
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Shuling Wang
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Peng Pan
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Tian Xia
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Rundong Wang
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Quancai Cai
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Xin Chang
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Fan Yang
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Lun Gu
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Zixuan He
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Jiayi Wu
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Qianqian Meng
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Tongchang Wang
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Qiwen Fang
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Xiaomei Mou
- Department of Gastroenterology, Yantai Zhifu Hospital
- Honggang Yu
- Department of Gastroenterology, Renmin Hospital of Wuhan University
- Jinghua Zheng
- Department of Gastroenterology, Yantaishan Hospital of Yantai City
- Cheng Bai
- Department of Gastroenterology, 967th Hospital of Joint Logistics Support Force
- Yingbin Zou
- Department of Gastroenterology
- Dongfeng Chen
- Department of Gastroenterology
- Xiaoping Zou
- Department of Gastroenterology, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School
- Xu Ren
- Digestive Disease Hospital of Heilongjiang Provincial Hospital
- Leiming Xu
- Department of Gastroenterology, Xinhua Hospital, Shanghai, Jiaotong University School of Medicine
- Ping Yao
- Department 1 of Gastroenterology, The First Affiliated Hospital of Xinjiang Medical University
- Guangsu Xiong
- Department of Gastroenterology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine
- Xu Shu
- Department of Gastroenterology, The First Affiliated Hospital of Nanchang University
- Tong Dang
- Inner Mongolia Institute of Digestive Diseases, The Second Affiliated Hospital of Baotou Medical College, Inner Mongolia University of Science and Technology
- Li Zhang
- Department of Gastroenterology, Beijing Rectum Hospital
- Wen Wang
- Department of Gastroenterology, 900th Hospital of Joint Logistics Support Force
- Shengchao Kang
- Department of Gastroenterology, 940th Hospital of Joint Logistics Support Force
- Hongfei Cao
- Department of Gastroenterology, Affiliated Hospital of Chifeng University
- Aixia Gong
- Department of Digestive Endoscopy, First Affiliated Hospital of Dalian Medical University
- Jun Li
- Department of Gastroenterology, The Second Affiliated Hospital of Kunming Medical University
- Heng Zhang
- Department of Gastroenterology, The Central Hospital of Wuhan, Tongji Medical College, Huazhong University of Science and Technology
- Yiqi Du
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Zhaoshen Li
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Yu Bai
- Department of Gastroenterology/Digestive Endoscopy Center, Changhai Hospital, Second Military Medical University/Naval Medical University, National Clinical Research Center for Digestive Diseases (Shanghai), National Quality Control Center of Digestive Endoscopy
- Gastrointestinal Early Cancer Prevention & Treatment Alliance of China (GECA)
- DOI
- https://doi.org/10.1186/s13045-022-01378-1
- Journal volume & issue
-
Vol. 15,
no. 1
pp. 1 – 6
Abstract
Abstract No fully validated risk-stratification strategies have been established in China where colonoscopies resources are limited. We aimed to develop and validate a fecal immunochemical test (FIT)-based risk-stratification model for colorectal neoplasia (CN); 10,164 individuals were recruited from 175 centers nationwide and were randomly allocated to the derivation (n = 6776) or validation cohort (n = 3388). Multivariate logistic analyses were performed to develop the National Colorectal Polyp Care (NCPC) score, which formed the risk-stratification model along with FIT. The NCPC score was developed from eight independent predicting factors and divided into three levels: low risk (LR 0–14), intermediate risk (IR 15–17), and high risk (HR 18–28). Individuals with IR or HR of NCPC score or FIT+ were classified as increased-risk individuals in the risk-stratification model and were recommended for colonoscopy. The IR/HR of NCPC score showed a higher prevalence of CNs (21.8%/32.8% vs. 11.0%, P < 0.001) and ACNs (4.3%/9.2% vs. 2.0%, P < 0.001) than LR, which was also confirmed in the validation cohort. Similar relative risks and predictive performances were demonstrated between non-specific gastrointestinal symptoms (NSGS) and asymptomatic cohort. The risk-stratification model identified 73.5% CN, 82.6% ACN, and 93.6% CRC when guiding 52.7% individuals to receive colonoscopy and identified 55.8% early-onset ACNs and 72.7% early-onset CRCs with only 25.6% young individuals receiving colonoscopy. The risk-stratification model showed a good risk-stratification ability for CN and early-onset CRCs in Chinese population, including individuals with NSGS and young age.
Keywords
- Risk-stratification model
- Fecal immunochemical test
- Early-onset colorectal cancer
- Colorectal cancer screening
