Diagnostic accuracy of features predicting lower gastrointestinal malignancy: a colonoscopy database review of 10 603 Chinese patients

AIM: The diagnostic accuracy of colonoscopic features in predicting colorectal cancer (CRC) malignancy was studied. METHOD: Consecutive patients who underwent first-time colonoscopy for lower gastrointestinal (GI) symptoms from 1998 to 2009 were identified. Gender, age, symptoms, endoscopic and pathologic findings were reviewed. RESULTS: There were 10,603 patients. The overall prevalence of malignancy was 3.0% (313). Among these, only 58% (181/313) had features indicative of tumour formation. The overall sensitivity and specificity was 9.6% and 94.1%, respectively. The overall positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio were 2.66, 0.96 and 2.77, respectively. CONCLUSION: A large proportion of Chinese patients with CRC presented without features indicative of tumour formation.