Publication Name	World Journal of Gastroenterology
Manuscript ID	109718
Country	Ecuador

Category	Gastroenterology & Hepatology
Manuscript Type	Prospective Study
Article Title	Serum homocysteine-based traffic light triage colonoscopy screening in colorectal cancer at-risk patients: A prospective cohort study
Manuscript Source	Unsolicited Manuscript
All Author List	Francisco Xavier Cano, José María Duque, Lucia Seoane, Miguel Puga-Tejada, Alejandra Espinoza de los Monteros, Pablo Bermeo, Eduardo Junquera, Daniel Pérez, Jimmy Martin-Delgado, Monica Santelli, Carla Pérez and Francisco Javier Pérez Rivera
Funding Agency and Grant Number
Corresponding Author	Francisco Xavier Cano, Doctorate Student, MD, Professor, Researcher, Instituto de Investigación e Innovación en Salud Integral, Universidad Católica de Santiago de Guayaquil, Av. Pdte. Carlos Julio Arosemena Tola, Guayaquil 090615, Guayas, Ecuador. francisco.cano@cu.ucsg.edu.ec
Key Words	Homocysteine; Predictive value of a test; Colonoscopy; Colorectal cancer; Cancer screening
Core Tip	In this study, we propose a traffic-light triage model based on serum homocysteine levels, sex, and age to prioritize colonoscopy after a positive fecal occult blood test. A green light (≤ 12 micromoles per liter in both sexes) indicates low risk and allows colonoscopy within three months. A yellow light (12-15 micromoles) in men suggests high-risk polyps and requires colonoscopy within one month. In women, the same range is already associated with adenocarcinoma and warrants immediate intervention. A red light (> 15 micromoles) in either sex is strongly associated with cancer and indicates the need for urgent colonoscopy.
Citation	Cano FX, Duque JM, Seoane L, Puga-Tejada M, Espinoza de los Monteros A, Bermeo P, Junquera E, Pérez D, Martin-Delgado J, Santelli M, Pérez C, Pérez Rivera FJ. Serum homocysteine-based traffic light triage colonoscopy screening in colorectal cancer at-risk patients: A prospective cohort study. World J Gastroenterol 2025; In press

Received	2025-05-20 07:07
Peer-Review Started	2025-05-20 07:07
To Make the First Decision
Return for Revision	2025-06-10 08:36
Revised	2025-07-05 19:28
Second Decision	2025-08-11 02:49
Accepted by Journal Editor-in-Chief
Accepted by Executive Editor-in-Chief	2025-08-13 09:25
Articles in Press	2025-08-13 09:25
Publication Fee Transferred
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ISSN	1007-9327 (print) and 2219-2840 (online)
Open Access	This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
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