Score Can Predict Likelihood of Advanced Colorectal Neoplasia in People Under 45

TUESDAY, March 18, 2025 (HealthDay News) — A simple score using clinical factors can predict the likelihood of advanced colorectal neoplasia (AN) in adults aged younger than 45 years undergoing colonoscopy, according to a study published online Feb. 13 in Digestive Diseases and Sciences.

Sarah Wehbe, M.D., from the Cleveland Clinic, and colleagues conducted a cross-sectional analysis involving adults aged 18 to 44 years who underwent colonoscopy between 2011 and 2021. The case group included those with AN, while those with normal colonoscopy or nonadvanced neoplasia comprised the control group. A model was constructed using backward elimination multivariable logistic regression methods based on significant associations between risk factors and the presence of AN in a randomly selected training set; the associations were confirmed in a validation set.

AN was identified in 346 (3.7 percent) of the 9,446 participants. The researchers found that body mass index, family history of colorectal cancer, and tobacco use were identified as risk factors for AN in the training set. The model exhibited moderate discriminatory power in the validation set (C-statistic, 0.645). The prediction score estimated the likelihood of detecting AN in the complete dataset from 1.8 to >14 percent for individuals scoring 1 and ≥9, respectively.

“The results of the model were used to develop a simple score that estimates the likelihood of detecting advanced colorectal neoplasia,” the authors write. “Once externally validated, the score may be useful for individualized colorectal cancer prevention strategies.”

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