Risk stratification for colon neoplasia: screening strategies using colonoscopy and computerized tomographic colonography.

摘要: Background & Aims: We developed a risk index to identify low-risk patients who may be screened for colorectal cancer with computerized tomographic colonography (CTC) instead of colonoscopy. Methods: Asymptomatic persons aged 50 years or older had undergone screening colonoscopy were randomized retrospectively derivation (n = 1512) and validation 1493) subgroups. (based on age, sex, family history) from the group. The expected results 3 strategies—universal colonoscopy, universal CTC, stratified strategy high-risk CTC patients—were then compared. Outcomes strategies extrapolated known colonic findings in each patient, using sensitivity/specificity values medical literature. Results validated subgroup. Results: In subgroup, detected 94% advanced neoplasia only 70% resulted largest total number procedures undergoing both procedures. 92% neoplasia, requiring 68% 36% patients, 4% having undergo 71% whereas 89%, 64% 40%. Unlike was independent assumptions sensitivity, specificity, threshold Conclusions: based our optimize yield colonoscopic resources reduce