A risk-scoring model based on clinical and laboratory risk factors could help predict advanced colorectal neoplasia (ACN) in adults younger than 50 years of age, according to research published in the Journal of Gastroenterology and Hepatology.

Hyo-Joon Yang, from Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea, and colleagues created a risk-scoring model that incorporated laboratory indicators for metabolic risks to predict ACN in asymptomatic adults who were younger and older than 50 years of age.

A total of 70,812 adults were included in the cross-sectional study. Participants received a colonoscopy screening in a single health check-up center between 2003 and 2012. The overall prevalence of ACN was 1.4%.

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The investigators created a 15-point score model that included age, sex, family history of colorectal cancer, smoking status, body mass index, serum levels of fasting glucose, low-density lipoprotein cholesterol, and carcinoembryonic antigen. They used the score to categorize participants into 5 risk groups (low, borderline, moderate, high, and very high).

The ACN prevalence was 0.7% in the low-risk group, 1.3% in the borderline-risk group, 2.7% in the moderate-risk group, 6.6% in the high-risk group, and 13.2% in the very high-risk group. The low-risk group had a 50.3% reduced risk of ACN compared with the borderline-risk group. In addition, the moderate-risk group had a 2-fold increased risk of ACN, the high-risk group had a 5-fold increased risk, and the very-high risk group had a 10-fold increased risk.

The researchers note that the scoring model showed significantly superior discriminative power than the Asian-Pacific colorectal screening score (P=.003).


  1. Yang HJ, Choi S, Park SK, et al. Derivation and validation of a risk scoring model to predict advanced colorectal neoplasm in adults of all ages. J Gastroenterol Hepatol. 2017;32(7):1328-1335. doi:10.1111/jgh.13711