Publication Name	World Journal of Gastrointestinal Oncology
Manuscript ID	121970
DOI	10.4251/wjgo.121970
Country	Türkiye

Category	Gastroenterology & Hepatology
Manuscript Type	Retrospective Cohort Study
Article Title	Clinical decision support for precolonoscopy cancer triage: A rule-out-oriented machine learning model for colorectal cancer risk
Manuscript Source	Unsolicited Manuscript
All Author List	Yunus Halil Polat and Mehmet Kayaalp
Funding Agency and Grant Number
Corresponding Author	Mehmet Kayaalp, MD, Department of Medical Oncology, Ankara University, Tıp Fakültesi Street, Mamak 06620, Ankara, Türkiye. kayaalpmehmet2728@gmail.com
Key Words	Colorectal cancer; Pre-colonoscopy triage; Machine learning; Gastroenterology; Precision medicine; Oncology; Decision support; Inflammatory indices
Core Tip	Colonoscopy capacity is limited and most procedures find no malignancy. Using only routinely available pre-colonoscopy laboratory parameters from 1604 consecutive patients (1.43% malignancy prevalence), we developed an extreme gradient boosting-based machine learning model with explainable SHapley Additive exPlanations analysis. Performance was validated through repeated stratified cross-validation, calibration analysis, and decision-curve analysis. The 10-feature SHapley Additive exPlanations-reduced model achieved a high sensitivity of 91% and a very low negative likelihood ratio of 0.17, with a calibrated negative predictive value of 99.7%. This rule-out-oriented tool may safely defer 40 to 67 colonoscopies per 100 patients in resource-limited settings.
Citation	Polat YH, Kayaalp M. Clinical decision support for precolonoscopy cancer triage: A rule-out-oriented machine learning model for colorectal cancer risk. World J Gastrointest Oncol 2026; In press DOI: https://doi.org/10.4251/wjgo.121970

Received	2026-04-08 01:00
Peer-Review Started	2026-04-08 01:02
First Decision by Editorial Office Director	2026-04-22 10:48
Return for Revision	2026-04-22 11:19
Revised	2026-05-06 07:36
Publication Fee Transferred	2026-05-07 13:29
Second Decision by Editor	2026-06-01 02:37
Second Decision by Editor-in-Chief
Final Decision by Editorial Office Director	2026-06-02 07:36
Articles in Press	2026-06-02 07:36
Edit the Manuscript by Language Editor
Typeset the Manuscript

ISSN	1948-5204 (online)
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Copyright	©Author(s) (or their employer(s)) 2026. No commercial re-use. See Permissions. Published by Baishideng Publishing Group Inc.
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