Modified predictive model incorporating the waist-to-hip ratio for advanced colorectal neoplasia: A step toward precision screening

Abstract

This editorial discusses an article by Liu et al, which focuses on the development and evaluation of a modified scoring model incorporating the waist-to-hip ratio for predicting advanced colorectal neoplasia (ACN). This editorial provides an overview of the study, including the background of ACN risk prediction, the study design, key findings, and the significance and limitations of the new model. The study identified independent risk factors for ACN and developed a 7-point scoring model with better predictive performance than existing models. However, challenges, such as generalizability across ethnic groups and selection bias, exist. Further research involving multi-ethnic cohorts and the integration of novel biomarkers is needed to improve the model and its clinical application.

Keywords: Advanced colorectal neoplasia; Abdominal obesity; Colorectal cancer screening; Risk scoring model; Waist-to-hip ratio

Core Tip: The new Asia-Pacific Colorectal Screening model, by incorporating the waist-to-hip ratio (WHR), better captures the metabolic risks driven by visceral fat and significantly improves the prediction accuracy. A high WHR (> 0.9 for men; > 0.85 for women) increases the risk of advanced colorectal neoplasms by 46%, enabling high-risk subgroups to receive prioritized colonoscopy. Future research should be expanded to multi-regional cohorts and incorporate more biomarkers (such as percentage of body fat, blood lipid and blood glucose levels), laboratory (stool DNA, polygenic risk scores, circulating tumor DNA) and imaging indicators (computed tomography-measured visceral fat area) to optimize the model.