Levent Erdem1, Erdem Akbal1, Erdem Koçak1, Dilek Tucer2, Enver Üçbilek3, Ahmet Uyanıkoğlu4, Can Dolapçıoğlu5, Emel Ahısalı Erim6, Göktuğ Şirin7, Hüseyin Alkım8, Aliye Soylu9, Levent Doğanay10, Ahmet Kemal Kürbüz11, Kamil Özdil10, Hakan Alagözlü12, Tuba Erürker Öztürk13, Mesut Sezikli14, Gupse Adalı10, Mehmet Çoban15, Saadettin Hülagü7, Halil Değertekin15, Alp Atasoy16, Filiz Akyüz17, İlham Gaffarlı18, Murat Saruç19, Engin Altıntaş3, Orhan Sezgin3, Nurdan Tözün19. 1. Department of Gastroenterology, Demiroğlu Bilim University Faculty of Medicine, İstanbul, Turkey. 2. Department of Gastroenterology, Edirne State Hospital, Edirne, Turkey. 3. Department of Gastroenterology, Mersin University Faculty of Medicine, Mersin, Turkey. 4. Department of Gastroenterology, Harran University Faculty of Medicine, Şanlıurfa, Turkey. 5. Department of Gastroenterology, Kartal Lütfü Kırdar Education and Research Hospital, İstanbul, Turkey. 6. Department of Gastroenterology, Koç University Faculty of Medicine, İstanbul, Turkey. 7. Department of Gastroenterology, Kocaeli University Faculty of Medicine, İstanbul, Turkey. 8. Department of Gastroenterology, Şişli Etfal Education and Research Hospital, İstanbul, Turkey. 9. Department of Gastroenterology, Bakırköy Education and Research Hospital, İstanbul, Turkey. 10. Department of Gastroenterology, Ümraniye Education and Research Hospital, İstanbul, Turkey. 11. Department of Gastroenterology, Kahramanmaraş Provincial Directorate of Health Necip Fazıl City Hospital, Kahramanmaraş, Turkey. 12. Department of Gastroenterology, Medical Park Hospital, Ankara, Turkey. 13. Department of Gastroenterology, Denizli State Hospital, Denizli, Turkey. 14. Department of Gastroenterology, Hitit University Faculty of Medicine, Çorum, Turkey. 15. Department of Gastroenterology, Ufuk University Faculty of Medicine, Ankara, Turkey. 16. Department of Gastroenterology, Mehmet Akif İnan Education and Research Hospital, Şanlıurfa, İstanbul. 17. Department of Gastroenterology, İstanbul University Faculty of Medicine, İstanbul, Turkey. 18. Department of Internal Medicine, Acıbadem University Faculty of Medicine, İstanbul, Turkey. 19. Department of Gastroenterology, Acıbadem University Faculty of Medicine, İstanbul, Turkey.
Abstract
BACKGROUND: Colorectal cancer is one of the most commonly diagnosed types of cancer worldwide. An early diagnosis and detection of colon cancer and polyp can reduce mortality and morbidity from colorectal cancer. Even though there are a variety of options in screen- ing tests, the question remains on which test is the most effective for the early detection of colorectal cancer. In this prospective study, we aimed to develop a simple, useful, effective, and reliable scoring system to detect colon polyp and colorectal cancer. METHODS: We enrolled 6508 subjects over the age of 18 from 16 centers, with colonoscopy screening. The age, smoking status, alcohol consumption, body mass index, polyp incidence, polyp size, number and localization, and pathologic findings were recorded. RESULTS: The age, male gender, obesity, smoking, and family history were found as independent risk factors for adenomatous polyp. We have developed a new scoring system which can be used for these factors. With a score of 4 or above, we found the following: sensitivity 81%, specificity 40%, positive predictive value 25.68%, and negative predictive value 89.84%, for adenomatous polyp detection; and sensitivity 96%, specificity 39%, positive predictive value 3.35%, negative predictive value 99.29%, for colorectal cancer detection. CONCLUSION: Even though the first colorectal cancer screening worldwide is generally performed for individuals over 50 years of age, we recommend that screening for colorectal cancer might begin for those under 50 years of age as well. Individuals with a score ≥ 4 must be included in the screening tests for colorectal cancer.
BACKGROUND: Colorectal cancer is one of the most commonly diagnosed types of cancer worldwide. An early diagnosis and detection of colon cancer and polyp can reduce mortality and morbidity from colorectal cancer. Even though there are a variety of options in screen- ing tests, the question remains on which test is the most effective for the early detection of colorectal cancer. In this prospective study, we aimed to develop a simple, useful, effective, and reliable scoring system to detect colon polyp and colorectal cancer. METHODS: We enrolled 6508 subjects over the age of 18 from 16 centers, with colonoscopy screening. The age, smoking status, alcohol consumption, body mass index, polyp incidence, polyp size, number and localization, and pathologic findings were recorded. RESULTS: The age, male gender, obesity, smoking, and family history were found as independent risk factors for adenomatous polyp. We have developed a new scoring system which can be used for these factors. With a score of 4 or above, we found the following: sensitivity 81%, specificity 40%, positive predictive value 25.68%, and negative predictive value 89.84%, for adenomatous polyp detection; and sensitivity 96%, specificity 39%, positive predictive value 3.35%, negative predictive value 99.29%, for colorectal cancer detection. CONCLUSION: Even though the first colorectal cancer screening worldwide is generally performed for individuals over 50 years of age, we recommend that screening for colorectal cancer might begin for those under 50 years of age as well. Individuals with a score ≥ 4 must be included in the screening tests for colorectal cancer.
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