Comparison of Diagnostic Performance Between Two Colorectal Tumor Screening Scoring Systems in the Tibetan Population in Lhasa,Xizang

Liu Huijun; Wang Yanbing; Wang Wenhai

doi:10.3969/j.issn.1004-3403.2025.04.010

Abstract：Objective To evaluate the application performance of the Asia-Pacific Colorectal Screening(APCS)score and the modified Asia-Pacific Colorectal Screening(M-APCS)score in screening for advanced colorectal tu-mors,and to provide evidence to optimize screening methods for early colorectal tumors in Xizang.Methods A to-tal of 226 Tibetan patients aged 50～70 years,who underwent colonoscopy at Lhasa People's Hospital from July,2022 to April,2024 were selected.All participants completed the APCS and M-APCS scoring before the examination.Dif-ferences in the detection rate and screening performance of advanced colorectal tumors between the two scoring sys-tems were compared.Results A total of 226 patients were included,with 107 males(47.3%)and 119 females(52.7%).The proportion of high-risk individuals identified by APCS and M-APCS was 18.6%(42/226)and 36.3%(82/226),respectively,with a significant difference(P<0.001).In the APCS-positive group,the detection rate of ad-vanced colorectal tumors was 14.3%(6/42),while in the APCS-negative group,it was 9.2%(17/184)(P>0.05).In the M-APCS-positive group,the detection rate was 15.9%(13/82),while in the M-APCS-negative group,it was 6.9%(10/144)(P<0.05).M-APCS showed better positive predictive value and sensitivity than APCS,but had a lower accu-racy;both scores demonstrated good specificity and predictive performance.Conclusion APCS is suitable for exclud-ing negative cases of colorectal cancer and advanced adenomas,with high specificity but low sensitivity;M-APCS performs better in terms of positive predictive value and sensitivity,making it more suitable for screening high-risk population.The performance of both scoring systems in screening for advanced adenomas needs improvement,and further optimization for the scoring systems is required to enhance screening performance.