{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:25:48Z","timestamp":1787009148124,"version":"build-2736575974"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,1,1]]},"abstract":"<jats:p>Background: There is no validated, discriminating, and easy-to-apply tool for estimating risk of colorectal neoplasia. We studied whether the National Cancer Institute\u2019s (NCI\u2019s) Colorectal Cancer (CRC) Risk Assessment Tool, which estimates future CRC risk, could estimate current risk for advanced colorectal neoplasia among average-risk persons.<\/jats:p>\n                  <jats:p>Methods: This cross-sectional study involved individuals age 50 to 80 years undergoing first-time screening colonoscopy. We measured medical and family history, lifestyle information, and physical measures and calculated each person\u2019s future CRC risk using the NCI tool\u2019s logistic regression equation. We related quintiles of future CRC risk to the current risk of advanced neoplasia (sessile serrated polyp or tubular adenoma \u2265 1\u2009cm, a polyp with villous histology or high-grade dysplasia, or CRC). All statistical tests were two-sided.<\/jats:p>\n                  <jats:p>Results: For 4457 (98.5%) with complete data (mean age = 57.2 years, SD\u2009=\u20096.6 years, 51.7% women), advanced neoplasia prevalence was 8.26%. Based on quintiles of five-year estimated absolute CRC risk, current risks of advanced neoplasia were 2.1% (95% confidence interval [CI] = 1.3% to 3.3%), 4.8% (95% CI\u2009=\u20093.5% to 6.4%), 6.4% (95% CI\u2009=\u20094.9% to 8.2%), 10.0% (95% CI\u2009=\u20098.1% to 12.1%), and 17.6% (95% CI\u2009=\u200915.5% to 20.6%; P &amp;lt; .001). For quintiles of estimated 10-year CRC risk, corresponding current risks for advanced neoplasia were 2.2% (95% CI\u2009=\u20091.4% to 3.5%), 4.8% (95% CI\u2009=\u20093.5% to 6.4%), 6.5% (95% CI\u2009=\u20095.0% to 8.3%), 9.3% (95% CI\u2009=\u20097.5% to 11.4%), and 18.4% (95% CI\u2009=\u200915.9% to 21.1%; P &amp;lt; .001). Among persons with an estimated five-year CRC risk above the median, current risk for advanced neoplasia was 12.8%, compared with 3.7% among those below the median (relative risk = 3.4, 95 CI\u2009=\u20092.7 to 4.4).<\/jats:p>\n                  <jats:p>Conclusions: The NCI\u2019s Risk Assessment Tool, which estimates future CRC risk, may be used to estimate current risk for advanced neoplasia, making it potentially useful for tailoring and improving CRC screening efficiency among average-risk persons.<\/jats:p>","DOI":"10.1093\/jnci\/djw181","type":"journal-article","created":{"date-parts":[[2016,8,31]],"date-time":"2016-08-31T22:33:29Z","timestamp":1472682809000},"source":"Crossref","is-referenced-by-count":30,"title":["Risk of Advanced Neoplasia Using the National Cancer Institute\u2019s Colorectal\n          Cancer Risk Assessment Tool"],"prefix":"10.1093","volume":"109","author":[{"given":"Thomas F","family":"Imperiale","sequence":"first","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Medicine, Indiana University School of Medicine; Regenstrief Institute, Inc. and Center for Innovation, Health Services Research and Development, Richard L. Roudebush VA Medical Center, Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Menggang","family":"Yu","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick O","family":"Monahan","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy E","family":"Stump","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebeka","family":"Tabbey","sequence":"additional","affiliation":[{"name":"Division of Gastroenterology and Hepatology, Department of Biostatistics, Indiana University School of Medicine, Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Glowinski","sequence":"additional","affiliation":[{"name":"Indianapolis Gastroenterology Research Foundation, Indianapolis, IN"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David F","family":"Ransohoff","sequence":"additional","affiliation":[{"name":"Department of Medicine University of North Carolina, Chapel Hill, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2016,8,31]]},"reference":[{"issue":"9927","key":"2019122007574893200_djw181-B1","doi-asserted-by":"crossref","first-page":"1490","DOI":"10.1016\/S0140-6736(13)61649-9","article-title":"Colorectal cancer","volume":"383","author":"Brenner","year":"2014","journal-title":"Lancet."},{"key":"2019122007574893200_djw181-B2","first-page":"51","article-title":"Prevalence of colorectal cancer screening among adults--Behavioral Risk\n            Factor Surveillance System, United States, 2010","volume":"61(Suppl)","author":"Joseph","year":"2012","journal-title":"MMWR\n            Suppl"},{"issue":"9","key":"2019122007574893200_djw181-B3","doi-asserted-by":"crossref","first-page":"627","DOI":"10.7326\/0003-4819-149-9-200811040-00243","article-title":"Screening for colorectal cancer: U.S. Preventive Services Task Force\n            recommendation statement","volume":"149","year":"2008","journal-title":"Ann Intern\n            Med."},{"issue":"3","key":"2019122007574893200_djw181-B4","doi-asserted-by":"crossref","first-page":"739","DOI":"10.1038\/ajg.2009.104","article-title":"American College of Gastroenterology guidelines for colorectal cancer\n            screening 2009 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tomographic\n            colonography screening for colorectal cancer in the medicare population","volume":"102","author":"Knudsen","year":"2010","journal-title":"J Natl Cancer\n            Inst."},{"issue":"4","key":"2019122007574893200_djw181-B8","doi-asserted-by":"crossref","first-page":"530","DOI":"10.1177\/0272989X11408730","article-title":"A systematic comparison of microsimulation models\n            of colorectal cancer: the role of assumptions about adenoma progression","volume":"31","author":"Kuntz","year":"2011","journal-title":"Med Decis\n            Making."},{"issue":"1","key":"2019122007574893200_djw181-B9","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1093\/epirev\/mxr004","article-title":"Cost-effectiveness of colorectal cancer screening","volume":"33","author":"Lansdorp-Vogelaar","year":"2011","journal-title":"Epidemiol\n            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Radiology","volume":"134","author":"Levin","year":"2008","journal-title":"Gastroenterology."},{"key":"2019122007574893200_djw181-B12","author":"Zauber","year":"2009"},{"key":"2019122007574893200_djw181-B13","first-page":"53","article-title":"Colorectal cancer incidence and screening - United States, 2008\n            and 2010","volume":"62(Suppl\n          3)","author":"Steele","year":"2013","journal-title":"MMWR Suppl"},{"issue":"44","key":"2019122007574893200_djw181-B14","first-page":"881","article-title":"Vital signs: colorectal cancer screening test use--United States,\n            2012","volume":"62","year":"2013","journal-title":"MMWR"},{"issue":"2","key":"2019122007574893200_djw181-B15","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.gastro.2005.05.056","article-title":"A comparison of the immunochemical fecal occult blood test and total\n            colonoscopy in the asymptomatic 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colonoscopy program for colorectal\n            cancer","volume":"142","author":"Pox","year":"2012","journal-title":"Gastroenterology."},{"issue":"4","key":"2019122007574893200_djw181-B19","doi-asserted-by":"crossref","first-page":"1151","DOI":"10.1053\/j.gastro.2005.07.059","article-title":"Projected national impact of colorectal cancer screening on clinical and\n            economic outcomes and health services demand","volume":"129","author":"Ladabaum","year":"2005","journal-title":"Gastroenterology."},{"issue":"2","key":"2019122007574893200_djw181-B20","doi-asserted-by":"crossref","first-page":"264","DOI":"10.1053\/j.gastro.2014.06.018","article-title":"Tailoring colonoscopic screening to individual risk","volume":"147","author":"Dominitz","year":"2014","journal-title":"Gastroenterology."},{"issue":"12","key":"2019122007574893200_djw181-B21","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1016\/j.amjmed.2012.05.026","article-title":"Tailoring colorectal cancer screening by considering risk of advanced\n            proximal neoplasia","volume":"125","author":"Imperiale","year":"2012","journal-title":"Am J\n            Med."},{"issue":"4","key":"2019122007574893200_djw181-B22","doi-asserted-by":"crossref","first-page":"1364","DOI":"10.1053\/j.gastro.2007.08.067","article-title":"Toward risk stratification for screening and surveillance of colorectal\n            neoplasia: one small step for the colonoscopist","volume":"133","author":"Imperiale","year":"2007","journal-title":"Gastroenterology."},{"issue":"2","key":"2019122007574893200_djw181-B23","doi-asserted-by":"crossref","first-page":"351","DOI":"10.1053\/j.gastro.2014.04.037","article-title":"Race, ethnicity, and sex affect risk for polyps\n            &gt;9\u2009mm in average-risk 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Reporting of Observational\n            Studies in Epidemiology (STROBE) statement: guidelines for reporting observational\n            studies","volume":"147","author":"von Elm","year":"2007","journal-title":"Ann Intern\n            Med."},{"issue":"3","key":"2019122007574893200_djw181-B27","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1056\/NEJM200007203430302","article-title":"Risk of advanced proximal neoplasms in asymptomatic adults according to the\n            distal colorectal findings","volume":"343","author":"Imperiale","year":"2000","journal-title":"N Engl J\n            Med."},{"issue":"12","key":"2019122007574893200_djw181-B28","doi-asserted-by":"crossref","first-page":"1218","DOI":"10.1056\/NEJMoa0803597","article-title":"Five-year risk of colorectal neoplasia after negative screening\n            colonoscopy","volume":"359","author":"Imperiale","year":"2008","journal-title":"N Engl J\n            Med."},{"issue":"10","key":"2019122007574893200_djw181-B29","doi-asserted-by":"crossref","first-page":"821","DOI":"10.1055\/s-0033-1344582","article-title":"Yield of the second surveillance colonoscopy based on the results of the\n            index and first surveillance colonoscopies","volume":"45","author":"Morelli","year":"2013","journal-title":"Endoscopy."},{"issue":"2","key":"2019122007574893200_djw181-B30","doi-asserted-by":"crossref","first-page":"152","DOI":"10.1097\/MCG.0b013e3181b5369b","article-title":"Colonoscopy performance in a large private practice: a comparison to\n            quality benchmarks","volume":"44","author":"Morelli","year":"2010","journal-title":"J Clin\n            Gastroenterol."},{"issue":"5","key":"2019122007574893200_djw181-B31","doi-asserted-by":"crossref","first-page":"339","DOI":"10.7326\/M14-1720","article-title":"Derivation and Validation of a Scoring System to Stratify Risk for Advanced\n            Colorectal Neoplasia in Asymptomatic Adults: A Cross-sectional Study","volume":"163","author":"Imperiale","year":"2015","journal-title":"Ann Intern\n            Med."},{"issue":"1","key":"2019122007574893200_djw181-B32","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.pcad.2010.04.001","article-title":"The Framingham Heart Study's impact on global risk\n            assessment","volume":"53","author":"Bitton","year":"2010","journal-title":"Prog Cardiovasc\n            Dis."},{"issue":"5","key":"2019122007574893200_djw181-B33","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1093\/jnci\/93.5.358","article-title":"Validation of the Gail et al. model of breast cancer risk prediction and\n            implications for chemoprevention","volume":"93","author":"Rockhill","year":"2001","journal-title":"J Natl Cancer\n            Inst."},{"issue":"3","key":"2019122007574893200_djw181-B34","doi-asserted-by":"crossref","first-page":"257","DOI":"10.1016\/j.amjmed.2006.05.055","article-title":"Development of a risk score for colorectal cancer in men","volume":"120","author":"Driver","year":"2007","journal-title":"Am J\n            Med."},{"issue":"10","key":"2019122007574893200_djw181-B35","doi-asserted-by":"crossref","first-page":"658","DOI":"10.1056\/NEJM199203053261002","article-title":"Long-term risk of colorectal cancer after excision of rectosigmoid\n            adenomas","volume":"326","author":"Atkin","year":"1992","journal-title":"N Engl J\n            Med."},{"issue":"12","key":"2019122007574893200_djw181-B36","first-page":"2648","article-title":"Use of colonoscopy as a primary screening test\n            for colorectal cancer in average risk people","volume":"98","author":"Bet\u00e9s","year":"2003","journal-title":"Am J\n            Gastroenterol."},{"issue":"4","key":"2019122007574893200_djw181-B37","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1053\/j.gastro.2006.08.015","article-title":"Risk stratification for colon neoplasia:\n            screening strategies using colonoscopy and computerized tomographic\n            colonography","volume":"131","author":"Lin","year":"2006","journal-title":"Gastroenterology."},{"issue":"9","key":"2019122007574893200_djw181-B38","doi-asserted-by":"crossref","first-page":"1236","DOI":"10.1136\/gut.2010.221168","article-title":"The Asia-Pacific Colorectal Screening score: a\n            validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic\n            Asian subjects","volume":"60","author":"Yeoh","year":"2011","journal-title":"Gut."},{"issue":"4","key":"2019122007574893200_djw181-B39","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.gie.2012.06.013","article-title":"Risk stratification for advanced proximal colon\n            neoplasm and individualized endoscopic screening for colorectal cancer by a risk-scoring\n            model","volume":"76","author":"Park","year":"2012","journal-title":"Gastrointest\n            Endosc."},{"issue":"6","key":"2019122007574893200_djw181-B40","doi-asserted-by":"crossref","first-page":"584","DOI":"10.1093\/aje\/kwr337","article-title":"Derivation and validation of a prediction rule\n            for estimating advanced colorectal neoplasm risk in average-risk\n          Chinese","volume":"175","author":"Cai","year":"2012","journal-title":"Am J\n            Epidemiol."},{"issue":"3","key":"2019122007574893200_djw181-B41","doi-asserted-by":"crossref","first-page":"478","DOI":"10.1016\/j.cgh.2013.08.042","article-title":"Development and validation of a scoring system to identify individuals at\n            high risk for advanced colorectal neoplasms who should undergo colonoscopy\n            screening","volume":"12","author":"Tao","year":"2014","journal-title":"Clin Gastroenterol\n            Hepatol."},{"issue":"7","key":"2019122007574893200_djw181-B42","doi-asserted-by":"crossref","first-page":"1112","DOI":"10.1136\/gutjnl-2013-304965","article-title":"A score to estimate the likelihood of detecting advanced colorectal\n            neoplasia at colonoscopy","volume":"63","author":"Kaminski","year":"2014","journal-title":"Gut."},{"issue":"7","key":"2019122007574893200_djw181-B43","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1001\/archinternmed.2012.332","article-title":"Adherence to colorectal cancer screening: a\n            randomized clinical trial of competing strategies","volume":"172","author":"Inadomi","year":"2012","journal-title":"Arch Intern\n            Med."},{"issue":"6","key":"2019122007574893200_djw181-B44","doi-asserted-by":"crossref","first-page":"1661","DOI":"10.1053\/j.gastro.2004.09.052","article-title":"Is there endoscopic capacity to provide\n            colorectal cancer screening to the unscreened population in the United\n            States?","volume":"127","author":"Seeff","year":"2004","journal-title":"Gastroenterology."},{"issue":"6","key":"2019122007574893200_djw181-B45","doi-asserted-by":"crossref","first-page":"1670","DOI":"10.1053\/j.gastro.2004.09.051","article-title":"How many endoscopies are performed for colorectal\n            cancer screening? Results from CDC's survey of endoscopic capacity","volume":"127","author":"Seeff","year":"2004","journal-title":"Gastroenterology."},{"issue":"1","key":"2019122007574893200_djw181-B46","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1001\/jama.2015.6177","article-title":"The Role of Physicians in the Era of Predictive Analytics","volume":"314","author":"Sniderman","year":"2015","journal-title":"JAMA."}],"container-title":["JNCI: Journal of the National Cancer Institute"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jnci\/article-pdf\/109\/1\/djw181\/31575729\/djw181.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/jnci\/article-pdf\/109\/1\/djw181\/31575729\/djw181.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,12,20]],"date-time":"2019-12-20T07:58:38Z","timestamp":1576828718000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jnci\/article\/doi\/10.1093\/jnci\/djw181\/2905646"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,8,31]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,8,31]]},"published-print":{"date-parts":[[2017,1,1]]}},"URL":"https:\/\/doi.org\/10.1093\/jnci\/djw181","relation":{},"ISSN":["0027-8874","1460-2105"],"issn-type":[{"value":"0027-8874","type":"print"},{"value":"1460-2105","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2017,1]]},"published":{"date-parts":[[2016,8,31]]},"article-number":"djw181"}}