ArticleCancer management and research2026
Development and Validation of a Traditional Chinese Medicine Constitution-Based Risk Score for Advanced Colorectal Neoplasia in Asymptomatic Chinese Adults.
Article in Cancer management and research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: The objective of this study was to develop and validate an innovative risk-stratification tool that integrates Traditional Chinese Medicine (TCM) constitution with clinical factors to enhance colorectal cancer (CRC) screening among asymptomatic Chinese adults. Methods: Conducted as a multicenter investigation, the study involved the randomization of 1430 asymptomatic participants into a derivation cohort (n=953) for model development and a validation cohort (n=477). Data on demographics, TCM constitution, and colonoscopy results were gathered using the TCM-Asia-Pacific Colorectal Screening (TCM-APCS) Questionnaire. A risk score was constructed through multivariable logistic regression analysis and its performance was assessed using receiver operating characteristic (ROC) analysis. Results: The TCM-APCS model proficiently stratified participants into low-, medium-, and high-risk categories. Among individuals classified within the high-risk group, there was a significantly elevated prevalence of both low-grade adenoma (44.1% compared to 7.3%, p<0.001) and advanced colorectal neoplasia (17.2% compared to 3.6%, p<0.001) when contrasted with the low-risk group. The model demonstrated strong discriminatory capability for advanced neoplasia, exhibiting enhanced predictive performance relative to the original Asia-Pacific CRC Screening score. Additionally, at the optimal threshold, the model accurately identified 71.1% of advanced neoplasia cases within the validation cohort. Conclusion: The TCM-APCS score is an effective, validated tool for risk-stratified CRC screening in China, enabling targeted resource allocation and enhanced screening efficiency in resource-constrained settings. Further external validation in diverse populations is warranted.
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