Luo WC, Yang YF, Wang Y, Zhang ZH. Endoscopic characterization and development of a prediction model for colorectal adenomatous polyps. World J Gastrointest Surg 2026; 18(2): 115902 [DOI: 10.4240/wjgs.v18.i2.115902]
Corresponding Author of This Article
Wen-Cai Luo, MM, Associate Chief Physician, Department of Gastroenterology, The People’s Hospital of Guanghan, No. 9 Section 3, Xi’an Road, Deyang 618300, Sichuan Province, China. lwc641105@163.com
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Medicine, Research & Experimental
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Retrospective Study
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Feb 27, 2026 (publication date) through Feb 26, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Luo WC, Yang YF, Wang Y, Zhang ZH. Endoscopic characterization and development of a prediction model for colorectal adenomatous polyps. World J Gastrointest Surg 2026; 18(2): 115902 [DOI: 10.4240/wjgs.v18.i2.115902]
World J Gastrointest Surg. Feb 27, 2026; 18(2): 115902 Published online Feb 27, 2026. doi: 10.4240/wjgs.v18.i2.115902
Endoscopic characterization and development of a prediction model for colorectal adenomatous polyps
Wen-Cai Luo, Yuan-Fu Yang, Yao Wang, Zhao-Hong Zhang
Wen-Cai Luo, Yao Wang, Zhao-Hong Zhang, Department of Gastroenterology, The People’s Hospital of Guanghan, Deyang 618300, Sichuan Province, China
Yuan-Fu Yang, Department of Oncology, The People’s Hospital of Guanghan, Deyang 618300, Sichuan Province, China
Author contributions: Luo WC and Yang YF designed this research study, collected and analyzed the data; Wang Y and Zhang ZH assisted in data collection; Wang Y was also responsible for statistical analysis; Luo WC drafted the manuscript; Yang YF supervised and coordinated the study; and all authors have approved the final version of the manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of People’s Hospital of Guanghan, China.
Informed consent statement: All participants provided written informed consent form for gastrointestinal endoscopy.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Technical appendix, statistical code, and dataset are available from the corresponding author.
Corresponding author: Wen-Cai Luo, MM, Associate Chief Physician, Department of Gastroenterology, The People’s Hospital of Guanghan, No. 9 Section 3, Xi’an Road, Deyang 618300, Sichuan Province, China. lwc641105@163.com
Received: October 29, 2025 Revised: November 24, 2025 Accepted: January 4, 2026 Published online: February 27, 2026 Processing time: 121 Days and 3.5 Hours
Abstract
BACKGROUND
Colorectal cancer carries a high mortality rate worldwide. Adenocarcinoma is its most common type, which is progressed following an adenoma-dysplasia-carcinoma sequence. Early accurate identification of individuals with a high risk for adenomas could facilitate prompt removal of adenomas and reduce colorectal cancer incidence.
AIM
To investigate the endoscopic features of colorectal adenomatous polyps and develop a prediction model for their occurrence.
METHODS
A total of 202 individuals undergoing their first colonoscope between January 2023 and January 2024 were selected. Endoscopic characteristics, demographics, clinical information, and laboratory results were compared between individuals with or without colorectal adenomas. Logistic regression was performed to identify risk factors for colorectal adenomatous polyps and construct a prediction model. A nomogram was developed using R (v3.5.2). Internal validation was conducted with 1000 bootstrap resamples to assess calibration and discrimination. External valuation was conducted in another 240 individuals.
RESULTS
In 202 participants, 75 (37.13%) and 127 (62.87%) had or had no colorectal adenomas, respectively. These adenomas varied in shape, size, and locations. Age ≥ 60 years, smoking, alcohol, fatty liver, gallbladder polyps, and abnormal glycosylated hemoglobin (HbA1c) were risk factors and were used to construct nomogram Logit(P) = -5.602 + 1.791 × age ≥ 60 years + 1.115 × smoking + 1.894 × alcohol + 1.727 × fatty liver + 1.749 × gallbladder polyps + 1.903 × abnormal HbA1c. Internal validation demonstrated excellent agreement between apparent and bias-corrected curves, strong discriminative ability (area under the curve of 0.889, 95% confidence interval: 0.841-0.938), and high net clinical benefit (threshold probability range 0.1-0.9). External validation also suggested excellent model performance.
CONCLUSION
Colorectal adenomas exhibit diverse characteristics. A nomogram incorporating age, smoking, alcohol, fatty liver, gallbladder polyps, and HbA1c provides a robust and accurate prediction for the risk of colorectal adenomas.
Core Tip: Colorectal adenomas varied significantly in shape, size, and locations. Age ≥ 60 years, smoking, alcohol, fatty liver, gallbladder polyps, and abnormal glycosylated hemoglobin were associated with the presence of colorectal adenomas. A nomogram Logit(P) = -5.602 + 1.791 × age ≥ 60 years + 1.115 × smoking + 1.894 × alcohol + 1.727 × fatty liver + 1.749 × gallbladder polyps + 1.903 × abnormal glycosylated hemoglobin showed excellent performance and could provide robust and accurate prediction for the risk of colorectal adenomatous polyps.
