{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T03:45:39Z","timestamp":1790307939095,"version":"4.1.0"},"reference-count":41,"publisher":"Wiley","issue":"17","license":[{"start":{"date-parts":[[2016,5,24]],"date-time":"2016-05-24T00:00:00Z","timestamp":1464048000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Stanford Cancer Institute Innovation Award"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancer"],"published-print":{"date-parts":[[2016,9]]},"abstract":"<jats:sec><jats:title>BACKGROUND<\/jats:title><jats:p>Tailoring screening to colorectal cancer (CRC) risk could improve screening effectiveness. Most CRCs arise from advanced neoplasia (AN) that dwells for years. To date, no available colorectal neoplasia risk score has been validated externally in a diverse population. The authors explored whether the National Cancer Institute (NCI) CRC risk\u2010assessment tool, which was developed to predict future CRC risk, could predict current AN prevalence in a diverse population, thereby allowing its use in risk stratification for screening.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS<\/jats:title><jats:p>This was a prospective examination of the relation between predicted 10\u2010year CRC risk and the prevalence of AN, defined as advanced or multiple (\u22653 adenomatous, \u22655 serrated) adenomatous or sessile serrated polyps, in individuals undergoing screening colonoscopy.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Among 509 screenees (50% women; median age, 58 years; 61% white, 5% black, 10% Hispanic, and 24% Asian), 58 (11%) had AN. The prevalence of AN increased progressively from 6% in the lowest risk\u2010score quintile to 17% in the highest risk\u2010score quintile (<jats:italic>P<\/jats:italic> = .002). Risk\u2010score distributions in individuals with versus without AN differed significantly (median, 1.38 [0.90\u20101.87] vs 1.02 [0.62\u20101.57], respectively; <jats:italic>P<\/jats:italic> = .003), with substantial overlap. The discriminatory accuracy of the tool was modest, with areas under the curve of 0.61 (95% confidence interval [CI], 0.54\u20100.69) overall, 0.59 (95% CI, 0.49\u20100.70) for women, and 0.63 (95% CI, 0.53\u20100.73) for men. The results did not change substantively when the analysis was restricted to adenomatous lesions or to screening procedures without any additional incidental indication.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The NCI CRC risk\u2010assessment tool displays modest discriminatory accuracy in predicting AN at screening colonoscopy in a diverse population. This tool may aid shared decision\u2010making in clinical practice. <jats:bold><jats:italic>Cancer<\/jats:italic> 2016<\/jats:bold>. \u00a9 <jats:italic>2016 American Cancer Society<\/jats:italic>. <jats:italic><jats:bold>Cancer 2016;122:2663\u20132670.<\/jats:bold> \u00a9 2016 American Cancer Society.<\/jats:italic><\/jats:p><\/jats:sec>","DOI":"10.1002\/cncr.30096","type":"journal-article","created":{"date-parts":[[2016,5,24]],"date-time":"2016-05-24T23:19:15Z","timestamp":1464131955000},"page":"2663-2670","source":"Crossref","is-referenced-by-count":25,"title":["Predicting advanced neoplasia at colonoscopy in a diverse population with the National Cancer Institute colorectal cancer risk\u2010assessment tool"],"prefix":"10.1002","volume":"122","author":[{"given":"Uri","family":"Ladabaum","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology Stanford University School of Medicine Stanford California"},{"name":"Department of Medicine Stanford University 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