Validation of the Asia Pacific Colorectal Screening (APCS) score in a Western population: An alternative screening tool

Corte, Crispin; Zhang, Lora; Ji, Chen; Westbury, Sean; Shaw, J. Ryan; Yeoh, Khay Guan; Leong, Rupert W.

doi:10.1111/jgh.13196

Cited by 17 publications

(24 citation statements)

References 33 publications

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“…Henceforth, The Asia-Pacific Working Group on CRC managed to identify important risk factors in Asian population and to derive a risk score tool which was named APCS score [10]. Subsequently, Thailand [16], Beijing [11,26], Japan [15], Hong Kong [12][13][14], South Korea [27], Vietnam [17], and Australia [28] all evaluated APCS score, which can be used as a cost-effective strategy in large asymptomatic cohort. In our study, the rate of ACRN in the asymptomatic group, LR, MR, and HR subgroups was 1.3, 8.6, and 20.3%.…”

Section: Discussionmentioning

confidence: 99%

Validation of Asia-Pacific Colorectal Screening Score for Asymptomatic Participants and Outpatients in Northwest District of China

Jiang

et al. 2019

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Introduction: Asia-Pacific Colorectal Screening (APCS) score has been implemented for colorectal cancer screening in asymptomatic cohort in many regions. However, no study has validated its efficiency in Asian outpatients with mild-selflimited gastrointestinal symptoms yet. The purpose of this study was to validate its efficiency in asymptomatic subjects and outpatients in Ningxia. Methods: The records of 329 asymptomatic participants and 300 outpatients were collected and analyzed from database in the General Hospital of Ningxia Medical University from September 2017 to April 2018. These 2 main groups were divided into 3 tiers based on the scores calculated by the category of APCS score. The detection rates of advanced colorectal neoplasia (ACRN) were further compared according to histopathological classifications of tissues acquired during colonoscopy. Results: Among the 329 participants screened in the asymptomatic cohort, 78 subjects (23.7%) were in the low-risk (LR) tier, 187 subjects (56.8%) in the moderate-risk (MR) tier, and 64 sub-jects (19.5%) in the high-risk (HR) tier. The percentage of ACRN in the LR, MR, and HR groups was 1.3, 8.6, and 20.3%, respectively. In the 300 outpatient cohorts, 78 patients (26%) were in the LR tier, 140 patients (46.7%) in the MR tier, and 82 patients (27.3%) in the HR tier. The detection rates of ACRN in the LR, MR, and HR groups were 0, 10, and 39%, respectively. Conclusion: APCS score is an effective method for ACRN screening in asymptomatic and also the outpatient subjects. Individuals with HR scores should be given priority for colonoscopy.

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Section: Discussionmentioning

confidence: 99%

Validation of Asia-Pacific Colorectal Screening Score for Asymptomatic Participants and Outpatients in Northwest District of China

Jiang

et al. 2019

Digestion

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“…They assessed the utility of the APCS system and the presence of MS components and found that in cases with obesity, the colorectal tumor detection rate significantly increased (59.5% vs 19.2% for the MR/HR group without obesity, P < 0.01). Utilization of the APCS scoring system in the Western population was examined in an Australian study by Corte et al[ 54 ]. APCS predicts the colonic findings in a Western population to a greater extent than in Asians, independent of the symptoms.…”

Section: Asia-pacific Colorectal Screening Scoring Systemmentioning

confidence: 99%

How significant is the association between metabolic syndrome and prevalence of colorectal neoplasia?

Suchánek¹,

Grega²,

Ngo³

et al. 2016

WJG

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The incidence and prevalence of metabolic syndrome (MS) and colorectal cancer (CRC) has been rising in developed countries. The association between these two diseases has been widely studied and reported. Less evidence is available about the relationship between MS and CRC precancerous lesions (adenomatous polyps, adenomas). The aim of this paper is to present an overview of our scientific understanding of that topic and its implication in clinical practice. One of the principal goals of current CRC secondary prevention efforts is to detect and remove the precancerous lesions in individuals with an average CRC risk to prevent the development of invasive cancer. MS is not currently considered a high-risk CRC factor and is therefore not included in the guidelines of organized screening programs. However, in light of growing scientific evidence, the approach to patients with MS should be changed. Metabolic risk factors for the development of adenomas and cancers are the same - obesity, impaired glucose tolerance, dyslipidemia, hypertension, cardiovascular diseases and diabetes mellitus type 2. Therefore, the key issue in the near future is the development of a simple scoring system, easy to use in clinical practice, which would identify individuals with high metabolic risk of colorectal neoplasia and would be used for individual CRC secondary prevention strategies. Currently, such scoring systems have been published based on Asian (Asia-Pacific Colorectal Screening Score; APCS) and Polish populations.

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“…Later, the usefulness of the APCS score as a preditor for advanced neoplasia has been studied in different racial population including Chinese, 14 Korean, 15 Vietnamese, 16 Thais, 17 and Western population. 18 An evidence based on the use of risk score (APCS score) combining with FIT to prioritize subjects for colonoscopy and to reduce colonoscopy workload is emerging. A previous study from Thailand evaluated the combination of the APCS score and FIT to predict advanced neoplasia and to prioritize colonoscopy.…”

Section: Introductionmentioning

confidence: 99%

Impact of Fecal Hb Levels on Advanced Neoplasia Detection and the Diagnostic Miss Rate For Colorectal Cancer Screening in High-Risk vs. Average-Risk Subjects: a Multi-Center Study

Aniwan

Ratanachu‐ek

Pongprasobchai

et al. 2017

Clinical and Translational Gastroenterology

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Objectives:The Asia-Pacific Colorectal Screening (APCS) scoring system was developed to identify high-risk subjects for advanced neoplasia. However, the appropriate fecal immunochemical test (FIT) cutoff for high-risk population may be different from that of average-risk population. We aimed to evaluate the FIT performance at different cutoffs in high-risk subjects undergoing colorectal cancer (CRC) screening.Methods:We prospectively enrolled asymptomatic subjects aged 50–75 years. Using the APCS score, subjects were stratified into either the average-risk or high-risk groups. All subjects were tested with one-time quantitative FIT and underwent colonoscopy. We compared the FIT performance for advanced neoplasia between two groups using different cutoffs (5 (FIT5), 10 (FIT10), 20 (FIT20), 30 (FIT30), and 40 (FIT40) μg Hb/g feces).Results:Overall, 1,713 subjects were recruited, and 1,222 (71.3%) and 491 (28.7%) were classified as average-risk and high-risk, respectively. Advanced neoplasia was detected in 90 (7.4%) of the average-risk subjects and 65 (13.2%) of the high-risk subjects. In the high-risk group, by decreasing the cutoff from FIT40 to FIT5, the sensitivity increased by 33.8 percentage points with decreased specificity by 11 percentage points. In the average-risk group, the sensitivity increased by 20 percentage points with decreased specificity by 9.6 percentage points. At the lowest cutoff (FIT5), the number of needed colonoscopies to find one advanced neoplasia was 2.8 and 6.1 for the high-risk and average-risk groups, respectively.Conclusions:Using an appropriate FIT cutoff for CRC screening in high-risk subjects could improve CRC screening performance and reduce the unnecessary colonoscopies. To maintain high sensitivity and specificity for advanced neoplasia, the optimal cutoff FIT in the high-risk subjects should be lower than that in the average-risk subjects.

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Validation of the Asia Pacific Colorectal Screening (APCS) score in a Western population: An alternative screening tool

Abstract: APCS predicts colonic findings in a Western population, to a greater extent than in Asians, independent to symptoms. Low body weight carries a strong protective effect against colonic neoplasia.

Cited by 17 publications

References 33 publications

Validation of Asia-Pacific Colorectal Screening Score for Asymptomatic Participants and Outpatients in Northwest District of China

Validation of Asia-Pacific Colorectal Screening Score for Asymptomatic Participants and Outpatients in Northwest District of China

How significant is the association between metabolic syndrome and prevalence of colorectal neoplasia?

Impact of Fecal Hb Levels on Advanced Neoplasia Detection and the Diagnostic Miss Rate For Colorectal Cancer Screening in High-Risk vs. Average-Risk Subjects: a Multi-Center Study

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