Imperiale et al developed a simple score for predicting the risk of advanced colorectal neoplasia in an asymptomatic adult. This can help to identify a patient who may benefit from more aggressive evaluation for an underlying colon cancer. The authors are from Indiana University, Roudebush Veterans Affairs Medical Center (Indianapolis), Indianapolis Gastroenterology Research Foundation and the University of North Caroline at Chapel Hill.
Patient selection: asymptomatic adult 50 to 80 years of age
Exclusions: inflammatory bowel disease, familial colorectal cancer syndrome, history of polyps
Outcome: advanced colorectal neoplasia (carcinoma, adenoma >= 1 cm, serrated polyp >= 1 cm, villous adenoma, high-grade dysplasia)
Parameter:
(1) age in years
(2) gender
(3) number of first-degree relatives with colorectal cancer
(4) waist circumference in inches and gender
(5) history of cigarette in years
|
Parameter |
Finding |
Points |
|
age in years |
< 55 years of age |
0 |
|
|
55 to > 60 years |
1 |
|
|
60 to < 65 years |
2 |
|
|
65 to < 70 years |
3 |
|
|
>= 70 years |
4 |
|
Gender |
female |
0 |
|
|
male |
1 |
|
first-degree relatives with a history of colon cancer |
0 |
0 |
|
|
>= 1 |
1 |
|
waist circumference |
< 37.4 inch in male |
0 |
|
|
37.4 to 47.2 inch male |
1 |
|
|
> 47.2 inch in male |
2 |
|
|
< 34.6 inch in female |
0 |
|
|
34.6 to 43.3 in female |
1 |
|
|
> 43.3 inch in female |
2 |
|
history of smoking |
0 pack years |
0 |
|
|
> 0 to < 30 pack years |
2 |
|
|
>= 30 pack years |
4 |
where:
• A waist size in males of 47.2 overlaps for medium and large waist circumferences.
• A waist size in females of 43.3 overlaps for medium and large waist circumference.
total score =
= SUM(points for all 5 parameters)
Interpretation:
• minimum score: 0
• maximum score: 12
• The higher the score the greater the risk for advanced colonic neoplasia.
|
Score |
Risk Group |
Percent with Colorectal Neoplasia |
|
0 |
very low |
2% |
|
1 to 3 |
low |
3 to 5% |
|
4 to 6 |
intermediate |
10 to 11% |
|
7 to 12 |
high |
22 to 25% |
Specialty: Hematology Oncology, Surgery, general, Gastroenterology
