| Titre : | Derivation and Validation of a Prediction Rule for Estimating Advanced Colorectal Neoplasm Risk in Average-Risk Chinese. (2012) |
| Auteurs : | Quan-Cai CAI ; Wen-Yuan BAI ; Zhi-Zheng GE ; Li-Ping HE ; . HONG FAN ; Zhi-Gang HUANG ; Xue-Liang JIANG ; . JIE CHEN ; You-Ming LI ; Yan-Qing LI ; Zhao-Shen LI ; . LI YANG ; Fu-Lin LIN ; Nong-Hua LV ; Shu-Ren MA ; . PING XIANG ; . XING CHEN ; Jian-Ming XU ; Hui-Min XU ; Yu-Xiu YANG ; . YI XIAO ; En-Da YU ; Ping-Hong ZHOU ; Center for Clinical Epidemiology and Evidence-based Medicine. Second Military Medical University. Shanghai. CHN ; Department of Gastroenterology. Changhai Hospital. Second Military Medical University. Shanghai. CHN |
| Type de document : | Article |
| Dans : | American journal of epidemiology (vol. 175, n° 6, 2012) |
| Pagination : | 584-593 |
| Langues: | Anglais |
| Mots-clés : | Estimation ; Facteur risque ; Risque ; Chine ; Endoscopie ; Logistique ; Modèle ; Dépistage ; Prévention santé ; Epidémiologie ; Asie ; Cancer |
| Résumé : | [BDSP. Notice produite par INIST-CNRS n9R0xC9B. Diffusion soumise à autorisation]. 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. |
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