Liu ZH, Cai ZL, Tong XJ, Sun YY, Zhuang XY, Yang XF, Fan JK. Modified scoring model incorporating waist-hip ratio for predicting advanced colorectal neoplasia. World J Clin Oncol 2025; 16(5): 106409 [DOI: 10.5306/wjco.v16.i5.106409]
Corresponding Author of This Article
Joe KM Fan, Consultant, MBBS (HK), MS (HKU), FRCS (Ed), Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. K445 Block K, Hong Kong 999077, China. drfanj@gmail.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Control Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Oncol. May 24, 2025; 16(5): 106409 Published online May 24, 2025. doi: 10.5306/wjco.v16.i5.106409
Modified scoring model incorporating waist-hip ratio for predicting advanced colorectal neoplasia
Zhong-Hui Liu, Zong-Lin Cai, Xiao-Jun Tong, Yang-Yang Sun, Xin-Yu Zhuang, Xue-Fei Yang, Joe KM Fan
Zhong-Hui Liu, Zong-Lin Cai, Xiao-Jun Tong, Xin-Yu Zhuang, Xue-Fei Yang, Department of Surgery, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
Yang-Yang Sun, Endoscopy Center, The University of Hong Kong-Shenzhen Hospital, Shenzhen 518000, Guangdong Province, China
Joe KM Fan, Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong 999077, China
Author contributions: Liu ZH, Cai ZL, Tong XJ, Sun YY, Zhuang XY, and Yang XF performed the research; Liu ZH and Fan JKM designed the study; Fan JKM revised and proofread the article; all of the authors read and approved the final version of the manuscript to be published.
Supported by The Guangdong Medical Research Foundation of China, No. A2020603.
Institutional review board statement: The Ethics Committee of the University of Hong Kong-Shenzhen Hospital approved this study in July 2019 (No. [2019]228).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors declare that they have no conflict of interest in this paper.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Data sharing statement: The datasets are available from the corresponding authors.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Joe KM Fan, Consultant, MBBS (HK), MS (HKU), FRCS (Ed), Department of Surgery, Li Ka Shing Faculty of Medicine, The University of Hong Kong, No. K445 Block K, Hong Kong 999077, China. drfanj@gmail.com
Received: February 25, 2025 Revised: March 29, 2025 Accepted: April 25, 2025 Published online: May 24, 2025 Processing time: 83 Days and 15.8 Hours
Abstract
BACKGROUND
Designing a feasible risk prediction model for advanced colorectal neoplasia (ACN) can enhance colonoscopy screening efficiency. Abdominal obesity is associated with colorectal cancer development.
AIM
To propose and evaluate a modified scoring model incorporating waist-hip ratio for the prediction of ACN.
METHODS
A total of 6483 patients who underwent their first screening or diagnostic colonoscopy in our center between 2020 and 2023 were recruited, in which 4592 were in the derivation cohort and 1891 formed a validation cohort. Multivariate logistic regression was used to investigate the risk factors of ACN in the derivation cohort based on endoscopic findings, and a new scoring model for ACN prediction was developed. The discriminatory capability of the scoring model was validated by the validation cohort.
RESULTS
Age, male gender, smoking, and wait-to-hip ratio were identified as independent risk factors for ACN, and a 7-point scoring model was developed. The prevalence of ACN was 3.3%, 9.3% and 18.5% in participants with scores of 0-2 [low risk (LR)], 3–4 [moderate risk (MR)], and 5–7 [high risk (HR)], respectively, in the derivation cohort. With the scoring model, 49.9%, 38.4%, and 11.7% of patients in the validation cohort were categorized as LR, MR, and HR, respectively. The corresponding prevalence rates of ACN were 5.0%, 10.3%, and 17.6%, respectively. The C-statistic of the new scoring model was 0.66, which was higher than that of the Asia-Pacific Colorectal Screening model (0.63).
CONCLUSION
A modified scoring model incorporating waist-hip ratio has an improved predictive performance in the prediction of ACN.
Core Tip: Designing a feasible risk prediction model for advanced colorectal neoplasia (ACN) can greatly improve the efficiency of colonoscopy screening. Abdominal obesity is associated with development of colorectal cancer. We proposed and evaluated a modified scoring model incorporating waist-hip ratio for the prediction of ACN in a Chinese population. Results showed that the modified scoring model had an improved predictive performance than the Asia-Pacific Colorectal Screening model in the prediction of ACN.
