{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T13:28:05Z","timestamp":1765546085618},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2016,2,8]],"date-time":"2016-02-08T00:00:00Z","timestamp":1454889600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2016,2,8]],"date-time":"2016-02-08T00:00:00Z","timestamp":1454889600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>This study developed a clinical scoring system to predict the risks of PN among screening participants for colorectal cancer. We recruited 5,789 Chinese asymptomatic screening participants who received colonoscopy in Hong Kong (2008\u20132014). From random sampling of 2,000 participants, the independent risk factors were evaluated for PN using binary regression analysis. The odds ratios for significant risk factors were used to develop a scoring system, with scores stratified into \u2018average risk\u2019 (AR):0\u20132 and \u2018high risk\u2019 (HR):3\u20135. The other 3,789 subjects formed an independent validation cohort. Each participant received a score calculated based on their risk factors. The performance of the scoring system was evaluated. The proportion of PN in the derivation and validation cohorts was 12.6% and 12.9%, respectively. Based on age, gender, family history, body mass index and self-reported ischaemic heart disease, 85.0% and 15.0% in the validation cohort were classified as AR and HR, respectively. Their prevalence of PN was 12.0% and 18.1%, respectively. Participants in the HR group had 1.51-fold (95% CI\u2009=\u20091.24\u20131.84, p\u2009&lt;\u20090.001) higher risk of PN than the AR group. The overall c-statistics of the prediction model was 0.71(0.02). The scoring system is useful in predicting the risk of PN to prioritize patients for colonoscopy.<\/jats:p>","DOI":"10.1038\/srep20396","type":"journal-article","created":{"date-parts":[[2016,2,8]],"date-time":"2016-02-08T10:28:47Z","timestamp":1454927327000},"update-policy":"http:\/\/dx.doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Validation of a risk prediction score for proximal neoplasia in colorectal cancer screening: a prospective colonoscopy study"],"prefix":"10.1038","volume":"6","author":[{"given":"Martin C.S.","family":"Wong","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica Y.L.","family":"Ching","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Victor C.W.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raymond S.Y.","family":"Tang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arthur K.C.","family":"Luk","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas Y.T.","family":"Lam","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sunny S.H.","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Siew C.","family":"Ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon S.M.","family":"Ng","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin C.Y.","family":"Wu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francis K.L.","family":"Chan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph J.Y.","family":"Sung","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2016,2,8]]},"reference":[{"key":"BFsrep20396_CR1","doi-asserted-by":"publisher","first-page":"2893","DOI":"10.1002\/ijc.25516","volume":"127","author":"J Ferlay","year":"2010","unstructured":"Ferlay, J. et al. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer 127, 2893\u20132917 (2010).","journal-title":"Int J Cancer"},{"key":"BFsrep20396_CR2","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1093\/jjco\/hym028","volume":"37","author":"Y Hirabayashi","year":"2007","unstructured":"Hirabayashi, Y. & Tanaka, S. Comparison of time trends in colorectal cancer incidence (1973\u201397) in East Asia, Europe and USA, from Cancer Incidence in Five Continents Vol. IV\u2013VIII. Jpn J Clin Oncol 37, 325\u20137 (2007).","journal-title":"Jpn J Clin Oncol"},{"key":"BFsrep20396_CR3","doi-asserted-by":"publisher","first-page":"871","DOI":"10.1016\/S1470-2045(05)70422-8","volume":"6","author":"JJY Sung","year":"2005","unstructured":"Sung, J. J. Y., Lau, J. Y. W. & Goh, K. L. Leung, W. K. For the on Asia Pacific Working Group on Colorectal Cancer. Increasing incidence of colorectal cancer in Asia: implications for screening. Lancet Oncol 6, 871\u20136 (2005).","journal-title":"Lancet Oncol"},{"key":"BFsrep20396_CR4","doi-asserted-by":"publisher","first-page":"1095","DOI":"10.1056\/NEJMoa1301969","volume":"369","author":"R Nishihara","year":"2013","unstructured":"Nishihara, R. et al. Long-Term Colorectal-Cancer Incidence and Mortality after Lower Endoscopy. N Engl J Med 369, 1095\u20131105 (2013).","journal-title":"N Engl J Med"},{"key":"BFsrep20396_CR5","doi-asserted-by":"publisher","first-page":"687","DOI":"10.1056\/NEJMoa1100370","volume":"366","author":"AG Zauber","year":"2012","unstructured":"Zauber, A. G. et al. Colonoscopic Polypectomy and Long-Term Prevention of Colorectal-Cancer Deaths. N Engl J Med 366, 687\u201396 (2012).","journal-title":"N Engl J Med"},{"key":"BFsrep20396_CR6","doi-asserted-by":"publisher","first-page":"87","DOI":"10.1111\/j.1365-2796.2011.02399.x","volume":"270","author":"M Bretthauer","year":"2011","unstructured":"Bretthauer, M. Colorectal cancer screening. J Intern Med 270, 87\u201398 (2011).","journal-title":"J Intern Med"},{"key":"BFsrep20396_CR7","doi-asserted-by":"publisher","first-page":"1570","DOI":"10.1053\/j.gastro.2008.02.002","volume":"134","author":"B Levin","year":"2008","unstructured":"Levin, B. et al. Screening and surveillance for the early detection of colorectal cancer and adenomatous polyps, 2008: a joint guideline from the American Cancer Society, the US Multi-Society Task Force on Colorectal Cancer and the American College of Radiology. Gastroenterology 134, 1570\u201395 (2008).","journal-title":"Gastroenterology"},{"key":"BFsrep20396_CR8","doi-asserted-by":"publisher","first-page":"b1846","DOI":"10.1136\/bmj.b1846","volume":"338","author":"G Hoff","year":"2009","unstructured":"Hoff, G., Grotmol, T., Skovlund, E. & Bretthauer, M. Norwegian Colorectal Cancer Prevention Study Group. Risk of colorectal cancer seven years after flexible sigmoidoscopy screening: randomized controlled trial. BMJ 338, b1846 (2009).","journal-title":"BMJ"},{"key":"BFsrep20396_CR9","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1016\/S0140-6736(10)60551-X","volume":"375","author":"WS Atkin","year":"2010","unstructured":"Atkin, W. S. et al. UK Flexible Sigmoidoscopy Trial Investigators. Once-only flexible sigmoidoscopy screening in prevention of colorectal cancer: a multicentre randomised controlled trial. Lancet 375, 1624\u201333 (2010).","journal-title":"Lancet"},{"key":"BFsrep20396_CR10","doi-asserted-by":"publisher","first-page":"1763","DOI":"10.1093\/jnci\/94.23.1763","volume":"94","author":"N Segnan","year":"2002","unstructured":"Segnan, N. et al. SCORE Working Group\u2014Italy. Baseline findings of the Italian multicentre randomised controlled trial of \u201conce-only sigmoidoscopy\u201d\u2014SCORE. J Natl Cancer Inst. 94, 1763\u201372 (2002).","journal-title":"J Natl Cancer Inst."},{"key":"BFsrep20396_CR11","doi-asserted-by":"publisher","first-page":"989","DOI":"10.1093\/jnci\/dji175","volume":"97","author":"JL Weissfeld","year":"2005","unstructured":"Weissfeld, J. L. et al. PLCO Project Team. Flexible sigmoidoscopy in the PLCO cancer screening trial: results from the baseline screening examination of a randomized trial. J Natl Cancer Inst. 97, 989\u201397 (2005).","journal-title":"J Natl Cancer Inst."},{"key":"BFsrep20396_CR12","doi-asserted-by":"crossref","unstructured":"Brenner, H., Stock, C. & Hoffmeister, M. Effect of screening sigmoidoscopy and screening colonoscopy on colorectal cancer incidence and mortality: systematic review and meta-analysis of randomised controlled trials and observational studies. BMJ 348, g2467 (2014).","DOI":"10.1136\/bmj.g2467"},{"key":"BFsrep20396_CR13","doi-asserted-by":"publisher","first-page":"1661","DOI":"10.1053\/j.gastro.2004.09.052","volume":"127","author":"LC Seeff","year":"2004","unstructured":"Seeff, L. C. et al. Is there endoscopic capacity to provide colorectal cancer screening to the unscreened population in the United States? Gastroenterology 127, 1661\u20131669 (2004).","journal-title":"Gastroenterology"},{"key":"BFsrep20396_CR14","doi-asserted-by":"publisher","first-page":"1670","DOI":"10.1053\/j.gastro.2004.09.051","volume":"127","author":"LC Seeff","year":"2004","unstructured":"Seeff, L. C. et al. How many endoscopies are performed for colorectal cancer screening? Results from CDC\u2019s survey of endoscopic capacity. Gastroenterology 127, 1670\u20131677 (2004).","journal-title":"Gastroenterology"},{"key":"BFsrep20396_CR15","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1136\/gutjnl-2013-306503","volume":"64","author":"JJ Sung","year":"2015","unstructured":"Sung, J. J. et al. the Asia Pacific Working Group on Colorectal Cancer Screening. An Updated Asia Pacific Consensus Recommendations on Colorectal Cancer Screening. Gut 64, 121\u2013132 (2015).","journal-title":"Gut"},{"key":"BFsrep20396_CR16","doi-asserted-by":"publisher","first-page":"959","DOI":"10.7326\/0003-4819-139-12-200312160-00005","volume":"139","author":"TF Imperiale","year":"2003","unstructured":"Imperiale, T. F. et al. Using risk for advanced proximal colonic neoplasia to tailor endoscopic screening for colorectal cancer. Ann Intern Med 139, 959\u201365 (2003).","journal-title":"Ann Intern Med"},{"key":"BFsrep20396_CR17","doi-asserted-by":"publisher","first-page":"1099","DOI":"10.1038\/ajg.2011.20","volume":"106","author":"BE Levitzky","year":"2011","unstructured":"Levitzky, B. E., Brown, C. C., Heeren, T. C. & Schroy, P. C. 3rd . Performance of a risk index for advanced proximal colorectal neoplasia among a racially\/ethnically diverse patient population (Risk index for advanced proximal neoplasia). Am J Gastroenterol 106, 1099\u20131106 (2011).","journal-title":"Am J Gastroenterol"},{"key":"BFsrep20396_CR18","doi-asserted-by":"publisher","first-page":"1181","DOI":"10.1016\/j.amjmed.2012.05.026","volume":"125","author":"TF Imperiale","year":"2012","unstructured":"Imperiale, T. F., Glowinski, E. A., Lin-Cooper, C. & Ransohoff, D. F. Tailoring colorectal cancer screening by considering risk of advanced proximal neoplasia. Am J Med 125, 1181\u20131187 (2012).","journal-title":"Am J Med"},{"key":"BFsrep20396_CR19","doi-asserted-by":"publisher","first-page":"1611","DOI":"10.1001\/jama.281.17.1611","volume":"281","author":"TR Levin","year":"1999","unstructured":"Levin, T. R. et al. Predicting advanced proximal colonic neoplasia with screening sigmoidoscopy. JAMA. 281, 1611\u20131617 (1999).","journal-title":"JAMA"},{"key":"BFsrep20396_CR20","doi-asserted-by":"publisher","first-page":"776","DOI":"10.1136\/gutjnl-2014-308002","volume":"64","author":"MCS Wong","year":"2015","unstructured":"Wong, M. C. S. et al. Prediction of proximal advanced neoplasia: a comparison of four existing sigmoidoscopy-based strategies in a Chinese population. Gut 64, 776\u201383 (2015).","journal-title":"Gut"},{"key":"BFsrep20396_CR21","doi-asserted-by":"publisher","first-page":"1130","DOI":"10.1136\/gutjnl-2013-305639","volume":"63","author":"MCS Wong","year":"2014","unstructured":"Wong, M. C. S. et al. A validated tool to predict colorectal neoplasia and inform screening choice for asymptomatic subjects. Gut 63, 1130\u20136 (2014).","journal-title":"Gut"},{"key":"BFsrep20396_CR22","doi-asserted-by":"publisher","first-page":"e70209","DOI":"10.1371\/journal.pone.0070209","volume":"8","author":"MCS Wong","year":"2013","unstructured":"Wong, M. C. S. et al. Perceived Obstacles of Colorectal Cancer Screening and their associated factors among 10,078 Chinese Participants. PLOS ONE 8, e70209 (2013).","journal-title":"PLOS ONE"},{"key":"BFsrep20396_CR23","doi-asserted-by":"publisher","first-page":"e60366","DOI":"10.1371\/journal.pone.0060366","volume":"8","author":"MCS Wong","year":"2013","unstructured":"Wong, M. C. S. et al. The Knowledge of Colorectal Cancer Symptoms and Risk Factors among 10,078 Screening Participants: are high risk individuals more knowledgeable? PLOS ONE 8, e60366 (2013).","journal-title":"PLOS ONE"},{"key":"BFsrep20396_CR24","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1016\/j.ypmed.2013.05.017","volume":"57","author":"MCS Wong","year":"2013","unstructured":"Wong, M. C. S. et al. Prospective cohort study of compliance with faecal immunochemical tests for colorectal cancer screening in Hong Kong. Prev Med. 57, 227\u201331 (2013).","journal-title":"Prev Med."},{"key":"BFsrep20396_CR25","doi-asserted-by":"publisher","first-page":"1541","DOI":"10.1007\/s10552-012-0031-x","volume":"23","author":"MCS Wong","year":"2012","unstructured":"Wong, M. C. S. et al. Changes in the choice of colorectal cancer screening tests in primary care settings from 7,845 prospectively collected surveys. Cancer Causes & Control 23, 1541\u20138 (2012).","journal-title":"Cancer Causes & Control"},{"key":"BFsrep20396_CR26","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1111\/j.1365-2036.2010.04312.x","volume":"32","author":"MCS Wong","year":"2010","unstructured":"Wong, M. C. S. et al. A Comparison of the acceptance of Immunochemical faecal occult blood test and colonoscopy in colorectal cancer screening: A prospective study among Chinese. Aliment Pharmacol Ther 32, 74\u201382 (2010).","journal-title":"Aliment Pharmacol Ther"},{"key":"BFsrep20396_CR27","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1136\/gut.2010.221168","volume":"60","author":"KG Yeoh","year":"2011","unstructured":"Yeoh, K. G. et al. for the Asia Pacific Working Group on Colorectal Cancer. The Asia-Pacific Colorectal Screening score: a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects. Gut 60, 1236\u20131241 (2011).","journal-title":"Gut"},{"key":"BFsrep20396_CR28","unstructured":"Institute of Medicine. Crossing the quality chasm: a new heath system for the 21st century. Washington, DC: National Academy Press, 2001. www.nap.edu\/books\/0309072808\/html\/index.html. Accessed August: 18, 2014."},{"key":"BFsrep20396_CR29","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.amepre.2003.09.011","volume":"26","author":"S Sheridan","year":"2004","unstructured":"Sheridan, S., Harris, R. & Woolf, S. Shared decision making about screening and chemoprevention. A suggested approach from the US Preventive Services Task Force. Am J Prev Med 26, 56\u201366 (2004).","journal-title":"Am J Prev Med"},{"key":"BFsrep20396_CR30","doi-asserted-by":"publisher","first-page":"169","DOI":"10.1056\/NEJM200007203430302","volume":"343","author":"TF Imperiale","year":"2000","unstructured":"Imperiale, T. F. et al. Risk of advanced proximal neoplasms in asymptomatic adults according to the distal colorectal findings. N Engl J Med 343, 169\u201374 (2000).","journal-title":"N Engl J Med"},{"key":"BFsrep20396_CR31","doi-asserted-by":"publisher","first-page":"5419","DOI":"10.1158\/0008-5472.CAN-09-4417","volume":"70","author":"R Meza","year":"2015","unstructured":"Meza, R., Jeon, J., Renehan, A. G. & Luebeck, E. G. Colorectal Cancer Incidence Trends in the United States and United Kingdom: Evidence of Right- to Left-Sided Biological Gradients with Implications for Screening. Cancer Research 70, 5419\u20135429 (2015).","journal-title":"Cancer Research"},{"key":"BFsrep20396_CR32","doi-asserted-by":"publisher","first-page":"576","DOI":"10.1136\/gutjnl-2011-300535","volume":"61","author":"RJC Steele","year":"2012","unstructured":"Steele, R. J. C. et al. Interval cancers in a FOBT-based colorectal cancer population screening programme: implications for stage, gender and tumour site. Gut 61, 576\u2013581 (2012).","journal-title":"Gut"},{"key":"BFsrep20396_CR33","doi-asserted-by":"publisher","first-page":"9380","DOI":"10.3748\/wjg.v21.i31.9380","volume":"21","author":"SE Kim","year":"2015","unstructured":"Kim, S. E. et al. Sex- and gender-specific disparities in colorectal cancer risk. World J Gastroenterol 21, 9380\u20139386 (2015).","journal-title":"World J Gastroenterol"},{"key":"BFsrep20396_CR34","doi-asserted-by":"publisher","first-page":"327","DOI":"10.7326\/0003-4819-122-5-199503010-00002","volume":"122","author":"E Giovannucci","year":"1995","unstructured":"Giovannucci, E. et al. Physical activity, obesity and risk for colon cancer and adenoma in men. Ann Intern Med. 122, 327\u201334 (1995).","journal-title":"Ann Intern Med."},{"key":"BFsrep20396_CR35","doi-asserted-by":"publisher","first-page":"906","DOI":"10.1093\/jnci\/dji164","volume":"97","author":"T Norat","year":"2005","unstructured":"Norat, T. et al. Meat, fish and colorectal cancer risk: the European Prospective Investigation into cancer and nutrition. J Natl Cancer Inst. 97, 906\u201316 (2005).","journal-title":"J Natl Cancer Inst."},{"key":"BFsrep20396_CR36","doi-asserted-by":"publisher","first-page":"e20456","DOI":"10.1371\/journal.pone.0020456","volume":"6","author":"DS Chan","year":"2011","unstructured":"Chan, D. S. et al. Red and processed meat and colorectal cancer incidence: meta-analysis of prospective studies. PLoS One. 6, e20456 (2011).","journal-title":"PLoS One."},{"key":"BFsrep20396_CR37","doi-asserted-by":"publisher","first-page":"4","DOI":"10.1186\/1471-230X-9-4","volume":"9","author":"Y Kim","year":"2009","unstructured":"Kim, Y., Kim, Y. & Lee, S. An association between colonic adenoma and abdominal obesity: a cross-sectional study. BMC Gastroenterol. 9, 4 (2009).","journal-title":"BMC Gastroenterol."},{"key":"BFsrep20396_CR38","doi-asserted-by":"publisher","first-page":"695","DOI":"10.1016\/j.cgh.2012.10.017","volume":"11","author":"JY Lee","year":"2013","unstructured":"Lee, J. Y. et al. Risk for coronary heart disease increases risk for colorectal neoplasm. Clin Gastroenterol Hepatol 11, 695\u2013702 (2013).","journal-title":"Clin Gastroenterol Hepatol"}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/srep20396.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep20396","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/srep20396.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,1,5]],"date-time":"2023-01-05T03:02:11Z","timestamp":1672887731000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/srep20396"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,8]]},"references-count":38,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,4,22]]}},"alternative-id":["BFsrep20396"],"URL":"https:\/\/doi.org\/10.1038\/srep20396","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,2,8]]},"assertion":[{"value":"19 June 2015","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2015","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 February 2016","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no competing financial interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"20396"}}