Development of Scoring System for Screening Colorectal Cancer: An Alternative Access to Health Care Services

Abstract

We aimed to develop a screening scoring scheme for colorectal cancer (CRC). The baseline and clinical information from the patients at the outpatient unit of Surgery Department, Faculty of Medicine Ramathibodi Hospital was used to develop a screening model. A binary logistic regression model was used to identify the independent risk variables and the beta-coefficients and a simple point scoring system was developed. The risk variables scoring system was based on 8 risk parameters: gender, family history of CRC in the first-degree relatives, exercise, bleeding per rectum, abdominal pain, weight loss, low density lipoprotein level and high density lipoprotein. The total score ranged from 0 to 11.5. The likelihood of colorectal cancer in people with low risk (scores < 3) was 1.77, moderate risk (scores 3.0-4.5) was 3.00, almost high risk (scores 4.5-5.5) was 5.91 and high risk patients (scores > 5.5) was 6.50. The receiver operating characteristic (ROC) curve of the study was 0.85 (95% CI 0.81-0.90). Our screening scoring system is simple and easy to use especially in primary care units. However, this study is the primary phase of developing of screening scoring system for colorectal cancer.