RT Journal Article SR Electronic T1 The Asia-Pacific Colorectal Screening score: a validated tool that stratifies risk for colorectal advanced neoplasia in asymptomatic Asian subjects JF Gut JO Gut FD BMJ Publishing Group Ltd and British Society of Gastroenterology SP 1236 OP 1241 DO 10.1136/gut.2010.221168 VO 60 IS 9 A1 Khay-Guan Yeoh A1 Khek-Yu Ho A1 Han-Mo Chiu A1 Feng Zhu A1 Jessica Y L Ching A1 Deng-Chyang Wu A1 Takahisa Matsuda A1 Jeong-Sik Byeon A1 Sang-Kil Lee A1 Khean-Lee Goh A1 Jose Sollano A1 Rungsun Rerknimitr A1 Rupert Leong A1 Kelvin Tsoi A1 Jaw-Town Lin A1 Joseph J Y Sung A1 for the Asia-Pacific Working Group on Colorectal Cancer YR 2011 UL http://gut.bmj.com/content/60/9/1236.abstract AB Objective To develop and validate a clinical risk score predictive of risk for colorectal advanced neoplasia for Asia.Methods A prospective, cross-sectional and multicentre study was carried out in tertiary hospitals in 11 Asian cities. The subjects comprise 2752 asymptomatic patients undergoing screening colonoscopy. From a development set of 860 asymptomatic subjects undergoing screening colonoscopy, multiple logistic regression was applied to identify significant risk factors for advanced colorectal neoplasia defined as invasive carcinoma or advanced adenoma. The ORs for significant risk factors were utilised to develop a risk score ranging from 0 to 7 (Asia-Pacific Colorectal Screening (APCS) score). Three tiers of risk were arbitrarily defined: 0–1 ‘average risk’ (AR); 2–3 ‘moderate risk’ (MR); and 4–7 ‘high risk’ (HR). Subjects undergoing screening colonoscopy between July 2006 and December 2007 were prospectively enrolled to form an independent validation group. Each subject had a personal APCS score calculated by summing the points attributed from the presence of risk factors in the individuals. The performance of the APCS score in predicting risk of advanced neoplasia was evaluated.Results There were 860 subjects in the derivation set and 1892 subjects in the validation set, with a baseline prevalence of advanced neoplasia of 4.5% and 3%, respectively. Applying the APCS stratification in the validation set, 559 subjects (29.5%) were in the AR tier, 966 subjects (51.1%) in the MR tier and 367 (19.4%) subjects in the HR tier. The prevalence of advanced neoplasia in the AR, MR and HR groups was 1.3, 3.2 and 5.2%, respectively. The subjects in the MR and HR tiers had 2.6-fold (95% CI 1.1 to 6.0) and 4.3-fold (95% CI 1.8 to 10.3) increased prevalence of advanced neoplasia, respectively, than those in the AR tier.Conclusions The APCS score based on age, gender, family history and smoking is useful in selecting asymptomatic Asian subjects for priority of colorectal screening.