Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review
Background and Aim This study systematically reviewed and meta‐analyzed the performance of the Asia–Pacific Colorectal Screening (APCS) score and its incorporation with the fecal immunochemical test (FIT) in stratifying the risk of advanced colorectal neoplasia (ACN). Methods We systematically searc...
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| Veröffentlicht in: | Journal of gastroenterology and hepatology 2024-06, Vol.39 (6), p.1000-1007 |
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| creator | Luu, Mai Ngoc Trinh, Nhi Ai Tran, Truc Le Thanh Dang, Thinh Phuong Hiyama, Toru Quach, Duc Trong |
| description | Background and Aim
This study systematically reviewed and meta‐analyzed the performance of the Asia–Pacific Colorectal Screening (APCS) score and its incorporation with the fecal immunochemical test (FIT) in stratifying the risk of advanced colorectal neoplasia (ACN).
Methods
We systematically searched for relevant articles in 12 electronic databases and registers on October 20, 2021, and updated the search to September 1, 2023. Random‐effect models were used to obtain the pooled performance statistics of the APCS score for ACN risk.
Results
From the 101 records screened, 13 eligible studies in the Asia–Pacific region involving 69 762 subjects who had undergone colonoscopy were enrolled. The pooled prevalences of ACN in the average‐risk (AR) tier (APCS 0–1), moderate‐risk (MR) tier (APCS 2–3), and high‐risk (HR) tier (APCS ≥ 4) groups were 0.9%, 3.1%, and 8.1%, respectively. Compared with the combined AR–MR group, the HR group was significantly associated with a higher ACN risk (pooled diagnostic odds ratio: 2.84, 95% confidence interval [CI]: 2.35–3.45, P |
| doi_str_mv | 10.1111/jgh.16523 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2934272365</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3069030322</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3533-7f660d7bbe9e12990b1ac4c95172e6c46d490300c23fe60d2106aef613a6bcd53</originalsourceid><addsrcrecordid>eNp1kc1qFEEQxxtRzJp48AWkwUs8TNJf05P2tiyaKAED0XPT01Od9Dofa9dswtx8BMG7D5cnSY8bFQTrUlD86lfd_Al5wdkRz3W8vro-4roU8hFZcKVYwSulH5MFO-FlYSQ3e-QZ4poxplhVPiV78kSJkjGzID8vIIUhda73QIdAx2ugS4zu7tuPC-djiJ6uhnZI4EfX0kufAPrYX1H0eUZjT3FMboxhmofzcor4ZRa55mZ2NtT_Xe9h2LQu29_QJe1gzFe-u961E0akrm8oTjhCl32eJriJcHtAngTXIjx_6Pvk87u3n1ZnxfnH0_er5XnhZSllUQWtWVPVNRjgwhhWc-eVNyWvBGivdKMMk4x5IQNkUnCmHQTNpdO1b0q5Tw533k0avm4BR9tF9NC2Lr95i1YYqUQlpJ7RV_-g62Gb8i_QSqbnM1KITL3eUT4NiAmC3aTYuTRZzuwcms2h2V-hZfblg3Fbd9D8IX-nlIHjHXAbW5j-b7IfTs92ynsrgqRc</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3069030322</pqid></control><display><type>article</type><title>Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review</title><source>Wiley Online Library Journals Frontfile Complete</source><creator>Luu, Mai Ngoc ; Trinh, Nhi Ai ; Tran, Truc Le Thanh ; Dang, Thinh Phuong ; Hiyama, Toru ; Quach, Duc Trong</creator><creatorcontrib>Luu, Mai Ngoc ; Trinh, Nhi Ai ; Tran, Truc Le Thanh ; Dang, Thinh Phuong ; Hiyama, Toru ; Quach, Duc Trong</creatorcontrib><description>Background and Aim
This study systematically reviewed and meta‐analyzed the performance of the Asia–Pacific Colorectal Screening (APCS) score and its incorporation with the fecal immunochemical test (FIT) in stratifying the risk of advanced colorectal neoplasia (ACN).
Methods
We systematically searched for relevant articles in 12 electronic databases and registers on October 20, 2021, and updated the search to September 1, 2023. Random‐effect models were used to obtain the pooled performance statistics of the APCS score for ACN risk.
Results
From the 101 records screened, 13 eligible studies in the Asia–Pacific region involving 69 762 subjects who had undergone colonoscopy were enrolled. The pooled prevalences of ACN in the average‐risk (AR) tier (APCS 0–1), moderate‐risk (MR) tier (APCS 2–3), and high‐risk (HR) tier (APCS ≥ 4) groups were 0.9%, 3.1%, and 8.1%, respectively. Compared with the combined AR–MR group, the HR group was significantly associated with a higher ACN risk (pooled diagnostic odds ratio: 2.84, 95% confidence interval [CI]: 2.35–3.45, P < 0.001). The APCS score showed a sensitivity of 0.42 (95% CI: 0.40–0.44) and a specificity of 0.86 (95% CI: 0.85–0.86) for predicting the ACN risk, with a weighted area under the curve of 0.642 (95% CI: 0.610–0.657). The combination of the APCS score and FIT substantially improved ACN risk identification, demonstrating pooled diagnostic odds ratios of 4.02 (95% CI: 2.50–6.49) in the AR–MR groups and 5.44 (95% CI: 1.89–15.63) in the MR–HR groups.
Conclusions
The APCS score could effectively stratify the ACN risk in the Asia–Pacific population. Incorporating FIT further improves its performance in identifying high‐risk subjects who should be prioritized for colonoscopy screenings.</description><identifier>ISSN: 0815-9319</identifier><identifier>ISSN: 1440-1746</identifier><identifier>EISSN: 1440-1746</identifier><identifier>DOI: 10.1111/jgh.16523</identifier><identifier>PMID: 38425009</identifier><language>eng</language><publisher>Australia: Wiley Subscription Services, Inc</publisher><subject>advanced colorectal neoplasia ; APCS ; Asia–Pacific ; Colon ; Colonoscopy ; colorectal neoplasms ; fecal immunochemical test ; Meta-analysis ; Statistical analysis</subject><ispartof>Journal of gastroenterology and hepatology, 2024-06, Vol.39 (6), p.1000-1007</ispartof><rights>2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd.</rights><rights>2024 Journal of Gastroenterology and Hepatology Foundation and John Wiley & Sons Australia, Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3533-7f660d7bbe9e12990b1ac4c95172e6c46d490300c23fe60d2106aef613a6bcd53</citedby><cites>FETCH-LOGICAL-c3533-7f660d7bbe9e12990b1ac4c95172e6c46d490300c23fe60d2106aef613a6bcd53</cites><orcidid>0009-0002-4472-3318 ; 0000-0002-2050-2839 ; 0000-0002-5843-232X ; 0009-0000-6886-5412 ; 0000-0003-0141-921X ; 0000-0002-8129-1764</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fjgh.16523$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fjgh.16523$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,776,780,1411,27901,27902,45550,45551</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/38425009$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Luu, Mai Ngoc</creatorcontrib><creatorcontrib>Trinh, Nhi Ai</creatorcontrib><creatorcontrib>Tran, Truc Le Thanh</creatorcontrib><creatorcontrib>Dang, Thinh Phuong</creatorcontrib><creatorcontrib>Hiyama, Toru</creatorcontrib><creatorcontrib>Quach, Duc Trong</creatorcontrib><title>Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review</title><title>Journal of gastroenterology and hepatology</title><addtitle>J Gastroenterol Hepatol</addtitle><description>Background and Aim
This study systematically reviewed and meta‐analyzed the performance of the Asia–Pacific Colorectal Screening (APCS) score and its incorporation with the fecal immunochemical test (FIT) in stratifying the risk of advanced colorectal neoplasia (ACN).
Methods
We systematically searched for relevant articles in 12 electronic databases and registers on October 20, 2021, and updated the search to September 1, 2023. Random‐effect models were used to obtain the pooled performance statistics of the APCS score for ACN risk.
Results
From the 101 records screened, 13 eligible studies in the Asia–Pacific region involving 69 762 subjects who had undergone colonoscopy were enrolled. The pooled prevalences of ACN in the average‐risk (AR) tier (APCS 0–1), moderate‐risk (MR) tier (APCS 2–3), and high‐risk (HR) tier (APCS ≥ 4) groups were 0.9%, 3.1%, and 8.1%, respectively. Compared with the combined AR–MR group, the HR group was significantly associated with a higher ACN risk (pooled diagnostic odds ratio: 2.84, 95% confidence interval [CI]: 2.35–3.45, P < 0.001). The APCS score showed a sensitivity of 0.42 (95% CI: 0.40–0.44) and a specificity of 0.86 (95% CI: 0.85–0.86) for predicting the ACN risk, with a weighted area under the curve of 0.642 (95% CI: 0.610–0.657). The combination of the APCS score and FIT substantially improved ACN risk identification, demonstrating pooled diagnostic odds ratios of 4.02 (95% CI: 2.50–6.49) in the AR–MR groups and 5.44 (95% CI: 1.89–15.63) in the MR–HR groups.
Conclusions
The APCS score could effectively stratify the ACN risk in the Asia–Pacific population. Incorporating FIT further improves its performance in identifying high‐risk subjects who should be prioritized for colonoscopy screenings.</description><subject>advanced colorectal neoplasia</subject><subject>APCS</subject><subject>Asia–Pacific</subject><subject>Colon</subject><subject>Colonoscopy</subject><subject>colorectal neoplasms</subject><subject>fecal immunochemical test</subject><subject>Meta-analysis</subject><subject>Statistical analysis</subject><issn>0815-9319</issn><issn>1440-1746</issn><issn>1440-1746</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><recordid>eNp1kc1qFEEQxxtRzJp48AWkwUs8TNJf05P2tiyaKAED0XPT01Od9Dofa9dswtx8BMG7D5cnSY8bFQTrUlD86lfd_Al5wdkRz3W8vro-4roU8hFZcKVYwSulH5MFO-FlYSQ3e-QZ4poxplhVPiV78kSJkjGzID8vIIUhda73QIdAx2ugS4zu7tuPC-djiJ6uhnZI4EfX0kufAPrYX1H0eUZjT3FMboxhmofzcor4ZRa55mZ2NtT_Xe9h2LQu29_QJe1gzFe-u961E0akrm8oTjhCl32eJriJcHtAngTXIjx_6Pvk87u3n1ZnxfnH0_er5XnhZSllUQWtWVPVNRjgwhhWc-eVNyWvBGivdKMMk4x5IQNkUnCmHQTNpdO1b0q5Tw533k0avm4BR9tF9NC2Lr95i1YYqUQlpJ7RV_-g62Gb8i_QSqbnM1KITL3eUT4NiAmC3aTYuTRZzuwcms2h2V-hZfblg3Fbd9D8IX-nlIHjHXAbW5j-b7IfTs92ynsrgqRc</recordid><startdate>202406</startdate><enddate>202406</enddate><creator>Luu, Mai Ngoc</creator><creator>Trinh, Nhi Ai</creator><creator>Tran, Truc Le Thanh</creator><creator>Dang, Thinh Phuong</creator><creator>Hiyama, Toru</creator><creator>Quach, Duc Trong</creator><general>Wiley Subscription Services, Inc</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7T5</scope><scope>7U9</scope><scope>H94</scope><scope>7X8</scope><orcidid>https://orcid.org/0009-0002-4472-3318</orcidid><orcidid>https://orcid.org/0000-0002-2050-2839</orcidid><orcidid>https://orcid.org/0000-0002-5843-232X</orcidid><orcidid>https://orcid.org/0009-0000-6886-5412</orcidid><orcidid>https://orcid.org/0000-0003-0141-921X</orcidid><orcidid>https://orcid.org/0000-0002-8129-1764</orcidid></search><sort><creationdate>202406</creationdate><title>Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review</title><author>Luu, Mai Ngoc ; Trinh, Nhi Ai ; Tran, Truc Le Thanh ; Dang, Thinh Phuong ; Hiyama, Toru ; Quach, Duc Trong</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3533-7f660d7bbe9e12990b1ac4c95172e6c46d490300c23fe60d2106aef613a6bcd53</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>advanced colorectal neoplasia</topic><topic>APCS</topic><topic>Asia–Pacific</topic><topic>Colon</topic><topic>Colonoscopy</topic><topic>colorectal neoplasms</topic><topic>fecal immunochemical test</topic><topic>Meta-analysis</topic><topic>Statistical analysis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Luu, Mai Ngoc</creatorcontrib><creatorcontrib>Trinh, Nhi Ai</creatorcontrib><creatorcontrib>Tran, Truc Le Thanh</creatorcontrib><creatorcontrib>Dang, Thinh Phuong</creatorcontrib><creatorcontrib>Hiyama, Toru</creatorcontrib><creatorcontrib>Quach, Duc Trong</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Immunology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of gastroenterology and hepatology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Luu, Mai Ngoc</au><au>Trinh, Nhi Ai</au><au>Tran, Truc Le Thanh</au><au>Dang, Thinh Phuong</au><au>Hiyama, Toru</au><au>Quach, Duc Trong</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review</atitle><jtitle>Journal of gastroenterology and hepatology</jtitle><addtitle>J Gastroenterol Hepatol</addtitle><date>2024-06</date><risdate>2024</risdate><volume>39</volume><issue>6</issue><spage>1000</spage><epage>1007</epage><pages>1000-1007</pages><issn>0815-9319</issn><issn>1440-1746</issn><eissn>1440-1746</eissn><abstract>Background and Aim
This study systematically reviewed and meta‐analyzed the performance of the Asia–Pacific Colorectal Screening (APCS) score and its incorporation with the fecal immunochemical test (FIT) in stratifying the risk of advanced colorectal neoplasia (ACN).
Methods
We systematically searched for relevant articles in 12 electronic databases and registers on October 20, 2021, and updated the search to September 1, 2023. Random‐effect models were used to obtain the pooled performance statistics of the APCS score for ACN risk.
Results
From the 101 records screened, 13 eligible studies in the Asia–Pacific region involving 69 762 subjects who had undergone colonoscopy were enrolled. The pooled prevalences of ACN in the average‐risk (AR) tier (APCS 0–1), moderate‐risk (MR) tier (APCS 2–3), and high‐risk (HR) tier (APCS ≥ 4) groups were 0.9%, 3.1%, and 8.1%, respectively. Compared with the combined AR–MR group, the HR group was significantly associated with a higher ACN risk (pooled diagnostic odds ratio: 2.84, 95% confidence interval [CI]: 2.35–3.45, P < 0.001). The APCS score showed a sensitivity of 0.42 (95% CI: 0.40–0.44) and a specificity of 0.86 (95% CI: 0.85–0.86) for predicting the ACN risk, with a weighted area under the curve of 0.642 (95% CI: 0.610–0.657). The combination of the APCS score and FIT substantially improved ACN risk identification, demonstrating pooled diagnostic odds ratios of 4.02 (95% CI: 2.50–6.49) in the AR–MR groups and 5.44 (95% CI: 1.89–15.63) in the MR–HR groups.
Conclusions
The APCS score could effectively stratify the ACN risk in the Asia–Pacific population. Incorporating FIT further improves its performance in identifying high‐risk subjects who should be prioritized for colonoscopy screenings.</abstract><cop>Australia</cop><pub>Wiley Subscription Services, Inc</pub><pmid>38425009</pmid><doi>10.1111/jgh.16523</doi><tpages>8</tpages><orcidid>https://orcid.org/0009-0002-4472-3318</orcidid><orcidid>https://orcid.org/0000-0002-2050-2839</orcidid><orcidid>https://orcid.org/0000-0002-5843-232X</orcidid><orcidid>https://orcid.org/0009-0000-6886-5412</orcidid><orcidid>https://orcid.org/0000-0003-0141-921X</orcidid><orcidid>https://orcid.org/0000-0002-8129-1764</orcidid></addata></record> |
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| identifier | ISSN: 0815-9319 |
| ispartof | Journal of gastroenterology and hepatology, 2024-06, Vol.39 (6), p.1000-1007 |
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| language | eng |
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| source | Wiley Online Library Journals Frontfile Complete |
| subjects | advanced colorectal neoplasia APCS Asia–Pacific Colon Colonoscopy colorectal neoplasms fecal immunochemical test Meta-analysis Statistical analysis |
| title | Performance of the Asia–Pacific Colorectal Screening score in stratifying the risk of advanced colorectal neoplasia: A meta‐analysis and systematic review |
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