Application Of Asia-Pacific Colorectal Screening Scoring System For Colorectal Advanced Neoplasia Screening

Aim To evaluate the Asia-Pacific Colorectal Screening(APCS) scoring system for colorectal advanced neoplasia(CAN) screening in asymptomatic and symptomatic subjects in Ningxia, China.Methods Subjects were enrolled from the General Hospital of Ningxia Medical University from Sept. 2014 to Apr. 2015. Asymptomatic participants who participated in The Ministry of Health of China(TMHC)-sponsored project and symptomatic participants who were symptomatic outpatients were recruited. These two main groups were further divided into 3 sub-groups based on the different levels of risk scores calculated by APCS score system.The detection rates of CAN were further compared according to histopathological classifications of tissues acquired during colonoscopy examinations of all patients.Results Among the 329 patients screened in the asymptomatic cohort, 78 subjects(23.7%) were in the average-risk(AR) tier, 187 subjects(56.8%) in the moderate-risk(MR)tier, and 64 subjects(19.5%) in the high-risk(HR) tier. The percentage of CAN in the AR,MR, and HR groups was 1.3%, 8.6%, and 20.3%, respectively. In the 300 symptomatic cohorts, 78 subjects(26%) were in the AR tier, 140 subjects(46.7%) in the MR tier, and82subjects(27.3%) in the HR tier. The detection rates of advanced neoplasia in the AR, MR,and HR groups were 1.3%, 10%, and 39%, respectively. The areas under the curve for advanced neoplasia in asymptomatic and symptomatic cohort were 0.77 and 0.84,respectively.Conclusions APCS scoring system can be applied for CAN screening and HRsub-group was determined to be more diagnostic value than AR and MR sub-groups.