Quantile-based fecal hemoglobin concentration for assessing colorectal neoplasms with 1,263,717 Taiwanese screenees

Szu Min Peng, Han Mo Chiu, Hsiao Hsuan Jen, Chen Yang Hsu, Sam Li Sheng Chen, Sherry Yueh Hsia Chiu, Amy Ming Fang Yen, Jean Ching Yuan Fann, Yi Chia Lee, Hsiu Hsi Chen

研究成果: 雜誌貢獻文章

摘要

Background: Although fecal hemoglobin concentration (f-Hb) was highly associated with the risk of colorectal neoplasms, current studies on this subject are hampered by skewedness of the data and the ordinal property of f-Hb has not been well studied yet. Our aim was to develop a quantile-based method to estimate adjusted percentiles (median) of fecal hemoglobin concentration and their derived prediction for the risk of multistage outcomes of colorectal disease. Methods: We used a 6-year follow-up cohort of Taiwanese nationwide colorectal screening program with fecal immunochemical testing (FIT) to obtain fecal hemoglobin concentration and applied accelerated failure time multi-variable analyses to make the comparison of adjusted median and other percentitles of fecal hemoglobin across four categories of colorectal carcinogenesis. We then predicted the risk of colorectal neoplasms on the basis of the corresponding percentile values by using accelerated failure time model with Bayesian inversion method. Results: The adjusted median fecal hemoglobin concentration of nonadvanced adenoma, advanced adenoma, and colorectal cancer were 57, 82, and 163 μg/g feces as opposed to 0 μg/g feces for the normal group. At 90 μg/g of f-Hb, the highly suspected cut-off for colorectal disease, the risks were 17% for non-advanced adenoma, 6% for advanced adenoma, and 9% for CRC. Life-time risks of each colorectal neoplasm were derived by percentiles of fecal hemoglobin concentration. Conclusion: Covariate-adjusted risk stratification for multistage outcomes of colorectal neoplasia were provided by using the quantiles of fecal hemoglobin concentration, yielding the estimated life-time risks of 25th to 75th quantitles, ranging from 0.5 to 44% for colorectal cancer, 0.2 to 46% for non-advanced adenoma, and 0.1 to 20% for advanced adenoma.
原文英語
文章編號94
期刊BMC Medical Informatics and Decision Making
19
發行號1
DOIs
出版狀態已發佈 - 五月 2 2019

指紋

Colorectal Neoplasms
Hemoglobins
Adenoma
Feces
Bayes Theorem
Carcinogenesis
Neoplasms

ASJC Scopus subject areas

  • Health Policy
  • Health Informatics

引用此文

Quantile-based fecal hemoglobin concentration for assessing colorectal neoplasms with 1,263,717 Taiwanese screenees. / Peng, Szu Min; Chiu, Han Mo; Jen, Hsiao Hsuan; Hsu, Chen Yang; Chen, Sam Li Sheng; Chiu, Sherry Yueh Hsia; Yen, Amy Ming Fang; Fann, Jean Ching Yuan; Lee, Yi Chia; Chen, Hsiu Hsi.

於: BMC Medical Informatics and Decision Making, 卷 19, 編號 1, 94, 02.05.2019.

研究成果: 雜誌貢獻文章

Peng, Szu Min ; Chiu, Han Mo ; Jen, Hsiao Hsuan ; Hsu, Chen Yang ; Chen, Sam Li Sheng ; Chiu, Sherry Yueh Hsia ; Yen, Amy Ming Fang ; Fann, Jean Ching Yuan ; Lee, Yi Chia ; Chen, Hsiu Hsi. / Quantile-based fecal hemoglobin concentration for assessing colorectal neoplasms with 1,263,717 Taiwanese screenees. 於: BMC Medical Informatics and Decision Making. 2019 ; 卷 19, 編號 1.
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title = "Quantile-based fecal hemoglobin concentration for assessing colorectal neoplasms with 1,263,717 Taiwanese screenees",
abstract = "Background: Although fecal hemoglobin concentration (f-Hb) was highly associated with the risk of colorectal neoplasms, current studies on this subject are hampered by skewedness of the data and the ordinal property of f-Hb has not been well studied yet. Our aim was to develop a quantile-based method to estimate adjusted percentiles (median) of fecal hemoglobin concentration and their derived prediction for the risk of multistage outcomes of colorectal disease. Methods: We used a 6-year follow-up cohort of Taiwanese nationwide colorectal screening program with fecal immunochemical testing (FIT) to obtain fecal hemoglobin concentration and applied accelerated failure time multi-variable analyses to make the comparison of adjusted median and other percentitles of fecal hemoglobin across four categories of colorectal carcinogenesis. We then predicted the risk of colorectal neoplasms on the basis of the corresponding percentile values by using accelerated failure time model with Bayesian inversion method. Results: The adjusted median fecal hemoglobin concentration of nonadvanced adenoma, advanced adenoma, and colorectal cancer were 57, 82, and 163 μg/g feces as opposed to 0 μg/g feces for the normal group. At 90 μg/g of f-Hb, the highly suspected cut-off for colorectal disease, the risks were 17{\%} for non-advanced adenoma, 6{\%} for advanced adenoma, and 9{\%} for CRC. Life-time risks of each colorectal neoplasm were derived by percentiles of fecal hemoglobin concentration. Conclusion: Covariate-adjusted risk stratification for multistage outcomes of colorectal neoplasia were provided by using the quantiles of fecal hemoglobin concentration, yielding the estimated life-time risks of 25th to 75th quantitles, ranging from 0.5 to 44{\%} for colorectal cancer, 0.2 to 46{\%} for non-advanced adenoma, and 0.1 to 20{\%} for advanced adenoma.",
keywords = "Colorectal cancer, Fecal hemoglobin, Screening",
author = "Peng, {Szu Min} and Chiu, {Han Mo} and Jen, {Hsiao Hsuan} and Hsu, {Chen Yang} and Chen, {Sam Li Sheng} and Chiu, {Sherry Yueh Hsia} and Yen, {Amy Ming Fang} and Fann, {Jean Ching Yuan} and Lee, {Yi Chia} and Chen, {Hsiu Hsi}",
year = "2019",
month = "5",
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doi = "10.1186/s12911-019-0812-1",
language = "English",
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T1 - Quantile-based fecal hemoglobin concentration for assessing colorectal neoplasms with 1,263,717 Taiwanese screenees

AU - Peng, Szu Min

AU - Chiu, Han Mo

AU - Jen, Hsiao Hsuan

AU - Hsu, Chen Yang

AU - Chen, Sam Li Sheng

AU - Chiu, Sherry Yueh Hsia

AU - Yen, Amy Ming Fang

AU - Fann, Jean Ching Yuan

AU - Lee, Yi Chia

AU - Chen, Hsiu Hsi

PY - 2019/5/2

Y1 - 2019/5/2

N2 - Background: Although fecal hemoglobin concentration (f-Hb) was highly associated with the risk of colorectal neoplasms, current studies on this subject are hampered by skewedness of the data and the ordinal property of f-Hb has not been well studied yet. Our aim was to develop a quantile-based method to estimate adjusted percentiles (median) of fecal hemoglobin concentration and their derived prediction for the risk of multistage outcomes of colorectal disease. Methods: We used a 6-year follow-up cohort of Taiwanese nationwide colorectal screening program with fecal immunochemical testing (FIT) to obtain fecal hemoglobin concentration and applied accelerated failure time multi-variable analyses to make the comparison of adjusted median and other percentitles of fecal hemoglobin across four categories of colorectal carcinogenesis. We then predicted the risk of colorectal neoplasms on the basis of the corresponding percentile values by using accelerated failure time model with Bayesian inversion method. Results: The adjusted median fecal hemoglobin concentration of nonadvanced adenoma, advanced adenoma, and colorectal cancer were 57, 82, and 163 μg/g feces as opposed to 0 μg/g feces for the normal group. At 90 μg/g of f-Hb, the highly suspected cut-off for colorectal disease, the risks were 17% for non-advanced adenoma, 6% for advanced adenoma, and 9% for CRC. Life-time risks of each colorectal neoplasm were derived by percentiles of fecal hemoglobin concentration. Conclusion: Covariate-adjusted risk stratification for multistage outcomes of colorectal neoplasia were provided by using the quantiles of fecal hemoglobin concentration, yielding the estimated life-time risks of 25th to 75th quantitles, ranging from 0.5 to 44% for colorectal cancer, 0.2 to 46% for non-advanced adenoma, and 0.1 to 20% for advanced adenoma.

AB - Background: Although fecal hemoglobin concentration (f-Hb) was highly associated with the risk of colorectal neoplasms, current studies on this subject are hampered by skewedness of the data and the ordinal property of f-Hb has not been well studied yet. Our aim was to develop a quantile-based method to estimate adjusted percentiles (median) of fecal hemoglobin concentration and their derived prediction for the risk of multistage outcomes of colorectal disease. Methods: We used a 6-year follow-up cohort of Taiwanese nationwide colorectal screening program with fecal immunochemical testing (FIT) to obtain fecal hemoglobin concentration and applied accelerated failure time multi-variable analyses to make the comparison of adjusted median and other percentitles of fecal hemoglobin across four categories of colorectal carcinogenesis. We then predicted the risk of colorectal neoplasms on the basis of the corresponding percentile values by using accelerated failure time model with Bayesian inversion method. Results: The adjusted median fecal hemoglobin concentration of nonadvanced adenoma, advanced adenoma, and colorectal cancer were 57, 82, and 163 μg/g feces as opposed to 0 μg/g feces for the normal group. At 90 μg/g of f-Hb, the highly suspected cut-off for colorectal disease, the risks were 17% for non-advanced adenoma, 6% for advanced adenoma, and 9% for CRC. Life-time risks of each colorectal neoplasm were derived by percentiles of fecal hemoglobin concentration. Conclusion: Covariate-adjusted risk stratification for multistage outcomes of colorectal neoplasia were provided by using the quantiles of fecal hemoglobin concentration, yielding the estimated life-time risks of 25th to 75th quantitles, ranging from 0.5 to 44% for colorectal cancer, 0.2 to 46% for non-advanced adenoma, and 0.1 to 20% for advanced adenoma.

KW - Colorectal cancer

KW - Fecal hemoglobin

KW - Screening

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U2 - 10.1186/s12911-019-0812-1

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