Development and external validation of a faecal immunochemical test-based prediction model for colorectal cancer detection in symptomatic patients
dc.contributor.author | Cubiella, Joaquín | |
dc.contributor.author | Vega, Pablo | |
dc.contributor.author | Salve, María | |
dc.contributor.author | Díaz-Ondina, Marta | |
dc.contributor.author | Alves, Maria Teresa | |
dc.contributor.author | Quintero, Enrique | |
dc.contributor.author | Álvarez-Sánchez, Victoria | |
dc.contributor.author | Fernández-Bañares, Fernando | |
dc.contributor.author | Boadas, Jaume | |
dc.contributor.author | Campo, Rafel | |
dc.contributor.author | Bujanda Fernández de Pierola, Luis | |
dc.contributor.author | Clofent, Joan | |
dc.contributor.author | Ferrandez, Ángel | |
dc.contributor.author | Torrealba, Leyanira | |
dc.contributor.author | Piñol, Virginia | |
dc.contributor.author | Rodríguez-Alcalde, Daniel | |
dc.contributor.author | Hernández, Vicent | |
dc.contributor.author | Fernández-Seara, Javier | |
dc.contributor.author | COLONPREDICT study investigators | |
dc.date.accessioned | 2019-04-10T10:39:11Z | |
dc.date.available | 2019-04-10T10:39:11Z | |
dc.date.issued | 2016-08-31 | |
dc.identifier.citation | BCM Medicine 14 : (2016) // Article ID 128 | es_ES |
dc.identifier.issn | 1741-7015 | |
dc.identifier.uri | http://hdl.handle.net/10810/32405 | |
dc.description.abstract | Background: Risk prediction models for colorectal cancer (CRC) detection in symptomatic patients based on available biomarkers may improve CRC diagnosis. Our aim was to develop, compare with the NICE referral criteria and externally validate a CRC prediction model, COLONPREDICT, based on clinical and laboratory variables. Methods: This prospective cross-sectional study included consecutive patients with gastrointestinal symptoms referred for colonoscopy between March 2012 and September 2013 in a derivation cohort and between March 2014 and March 2015 in a validation cohort. In the derivation cohort, we assessed symptoms and the NICE referral criteria, and determined levels of faecal haemoglobin and calprotectin, blood haemoglobin, and serum carcinoembryonic antigen before performing an anorectal examination and a colonoscopy. A multivariate logistic regression analysis was used to develop the model with diagnostic accuracy with CRC detection as the main outcome. Results: We included 1572 patients in the derivation cohort and 1481 in the validation cohorts, with a 13.6 % and 9. 1 % CRC prevalence respectively. The final prediction model included 11 variables: age (years) (odds ratio [OR] 1.04, 95 % confidence interval [CI] 1.02-1.06), male gender (OR 2.2, 95 % CI 1.5-3.4), faecal haemoglobin >= 20 mu g/g (OR 17.0, 95 % CI 10.0-28.6), blood haemoglobin <10 g/dL (OR 4.8, 95 % CI 2.2-10.3), blood haemoglobin 10-12 g/dL (OR 1.8, 95 % CI 1.1-3.0), carcinoembryonic antigen >= 3 ng/mL (OR 4.5, 95 % CI 3.0-6.8), acetylsalicylic acid treatment (OR 0.4, 95 % CI 0.2-0.7), previous colonoscopy (OR 0.1, 95 % CI 0.06-0.2), rectal mass (OR 14.8, 95 % CI 5.3-41.0), benign anorectal lesion (OR 0.3, 95 % CI 0.2-0.4), rectal bleeding (OR 2.2, 95 % CI 1.4-3.4) and change in bowel habit (OR 1.7, 95 % CI 1.1-2.5). The area under the curve (AUC) was 0.92 (95 % CI 0.91-0.94), higher than the NICE referral criteria (AUC 0.59, 95 % CI 0.55-0.63; p < 0.001). On the basis of the thresholds with 90 % (5.6) and 99 % (3.5) sensitivity, we divided the derivation cohort into three risk groups for CRC detection: high (30.9 % of the cohort, positive predictive value [PPV] 40.7 %, 95 % CI 36.7-45.9 %), intermediate (29.5 %, PPV 4.4 %, 95 % CI 2.8-6.8 %) and low (39.5 %, PPV 0.2 %, 95 % CI 0.0-1.1 %). The discriminatory ability was equivalent in the validation cohort (AUC 0.92, 95 % CI 0.90-0.94; p = 0.7). Conclusions: COLONPREDICT is a highly accurate prediction model for CRC detection. | es_ES |
dc.description.sponsorship | This study was funded by a grant from Instituto de Salud Carlos III (PI11/00094). JC and VH have received an intensification grant through the European Commission funded "BIOCAPS" project (FP-7-REGPOT 2012-2013-1, Grant agreement no. FP7-316265). The validation cohort recruitment was funded by a grant from Fundacio de la Marato TV3 2012 (785/U/2013). The funding institutions had no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the article for publication. | es_ES |
dc.language.iso | eng | es_ES |
dc.publisher | Biomed Central | es_ES |
dc.relation | info:eu-repo/grantAgreement/EC/FP7/316265 | es_ES |
dc.rights | info:eu-repo/semantics/openAccess | es_ES |
dc.rights.uri | http://creativecommons.org/licenses/by/3.0/es/ | * |
dc.subject | colorectal cancer | es_ES |
dc.subject | faecal immunochemical test | es_ES |
dc.subject | colonoscopy | es_ES |
dc.subject | diagnostic accuracy | es_ES |
dc.subject | risk stratification | es_ES |
dc.subject | prompt diagnosis | es_ES |
dc.subject | consultation questionnaire | es_ES |
dc.subject | scoring system | es_ES |
dc.subject | primary-care | es_ES |
dc.subject | risk | es_ES |
dc.subject | hemoglobin | es_ES |
dc.subject | guidelines | es_ES |
dc.subject | quality | es_ES |
dc.subject | indicators | es_ES |
dc.subject | diagnosis | es_ES |
dc.subject | people | es_ES |
dc.title | Development and external validation of a faecal immunochemical test-based prediction model for colorectal cancer detection in symptomatic patients | es_ES |
dc.type | info:eu-repo/semantics/article | es_ES |
dc.rights.holder | This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. | es_ES |
dc.rights.holder | Atribución 3.0 España | * |
dc.relation.publisherversion | https://bmcmedicine.biomedcentral.com/articles/10.1186/s12916-016-0668-5 | es_ES |
dc.identifier.doi | 10.1186/s12916-016-0668-5 | |
dc.departamentoes | Medicina | es_ES |
dc.departamentoeu | Medikuntza | es_ES |
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