Comparison of Three Prediction Rules for Assessing the Risk of Gastric Cancer in Chinese Health Examination Populations

Abstract

Background The current consensus regarding gastric cancer screening in China recommends Li’s Scoring System to assess the risk of gastric cancer. Objectives To compare the predictive capacity of three prediction rules: the ABC method, the Scoring System from the Japan Public Health Center (JPHC), and Li’s Scoring System in Chinese health examination populations. Methods We retrospectively evaluated 1,436 patients undergoing gastroscopy. The patients were classified into three groups (low, medium and high risk) according to each rule. The predictive capacity of three rules to assess the risk of gastric cancer was compared. Results A total of 28 (1.95%) cases with gastric cancer were detected. The Scoring System from JPHC and Li’s Scoring System performed similarly, and the areas under the receiver-operating characteristic (ROC) curves (AUC) were 0.745 (95%CI: 0.722–0.767), and 0.739 (95%CI: 0.715–0.761), respectively. And the AUC for the ABC method was 0.642 (95%CI: 0.617–0.667), significantly lower than that for the Scoring System from JPHC (p < 0.05).Li’s Scoring System had the highest sensitivity, significantly higher than that of the Scoring System from JPHC (85.71% vs 53.57%, p<0.05). Larger proportions of low-risk patients were diagnosed as gastric cancer by the Scoring System from JPHC (1.99%) and ABC method (0.99%) than by Li’s Scoring System (0.55%). Conclusions The Scoring System from JPHC and Li’s Scoring System have a similar performance in assessing the risk of gastric cancer, but Li’s Scoring System is more effective in Chinese health examination populations because of the lowest probability of missed diagnosis.