NCI Colorectal Cancer Risk Assessment Tool Estimates Current Risk of Advanced Neoplasia

Key Points

  • Estimated future colorectal cancer risk was associated with the current risk of advanced neoplasia.
  • The current risk of advanced neoplasia was 12.8% vs 3.7% for estimated 5-year colorectal cancer risk above vs below the median.

In a study reported in the Journal of the National Cancer Institute, Imperiale et al found that the National Cancer Institute (NCI) colorectal cancer risk assessment tool was able to estimate the current risk for advanced colorectal neoplasia.

Study Details

The study involved 4,457 persons aged 50 to 80 years undergoing first-time screening colonoscopy. The NCI tool was used to calculate the future risk of colorectal cancer on the basis of medical and family histories, lifestyle information, and physical measures. Advanced neoplasia was defined as a sessile serrated polyp or tubular adenoma ≥ 1 cm, a polyp with villous histology or high-grade dysplasia, or colorectal cancer. Subjects had a mean age of 57 years, and 52% were women.

Correlation of Risk

The overall prevalence of advanced neoplasia was 8.26%. Based on quintiles of increasing 5-year estimated absolute colorectal cancer risk, current risks of advanced neoplasia were 2.1%, 4.8%, 6.4%, 10.0%, and 17.6% (P < .001). For quintiles of estimated 10-year colorectal cancer risk, current risks for advanced neoplasia were 2.2%, 4.8%, 6.5%, 9.3%, and 18.4% (P < .001). The current risk of advanced neoplasia was 12.8% vs 3.7% for estimated 5-year colorectal cancer risk above vs below the median (relative risk  = 3.4, 95% confidence interval = 2.7–4.4).

The investigators concluded: “The NCI’s Risk Assessment Tool, which estimates future [colorectal cancer] risk, may be used to estimate current risk for advanced neoplasia, making it potentially useful for tailoring and improving [colorectal cancer] screening efficiency among average-risk persons.”

The study was supported by the NCI, the Walther Cancer Institute, Indiana University Simon Cancer Center, and the Indiana Clinical Translational Sciences Institute.

Thomas F. Imperiale, MD, of Indiana University School of Medicine, is the corresponding author of the Journal of the National Cancer Institute article.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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