Risk of Metachronous Colorectal Advanced Neoplasia and Cancer in Patients With 3-4 Nonadvanced Adenomas at Index Colonoscopy: A Systematic Review and Meta-Analysis
- Abstract
- INTRODUCTION: This systematic review and meta-analysis evaluated the available evidence on the risk of metachronous advanced neoplasia (AN) and colorectal cancer (CRC) in patients with 3-4 nonadvanced adenomas (NAAs). METHODS: We searched MEDLINE, EMBASE, and Cochrane Library databases up to January 2021 for studies evaluating metachronous AN and CRC risk by comparing 3 groups (1-2 vs 3-4 vs ≥5 NAAs) at index colonoscopy. The estimates for risk of metachronous AN and CRC were evaluated using random-effects models. RESULTS: Fifteen studies (n = 36,375) were included. The risk of metachronous AN was significantly higher in the 3-4 NAAs group than in the 1-2 NAAs group (relative risk [RR] 1.264, 95% confidence interval [CI] 1.053-1.518, P = 0.012; I2 = 0%); there was no difference between the ≥ 5 NAAs and 3-4 NAAs groups (RR 1.962, 95% CI 0.972-3.958, P = 0.060; I2 = 68%). The risks of metachronous CRC between the 1-2 NAAs and 3-4 NAAs groups (RR 2.663, 95% CI 0.391-18.128, P = 0.317; I2 = 0%) or the 3-4 NAAs and ≥ 5 NAAs groups (RR 1.148, 95% CI 0.142-9.290, P = 0.897; I2 = 0%) were not significantly different. DISCUSSION: Although the risk of metachronous AN was greater in the 3-4 NAAs group than in the 1-2 NAAs group, the risk of metachronous AN and CRC between the 3-4 NAAs and ≥ 5 NAAs groups was not different. This suggests that further studies on metachronous AN and CRC risk in the 3-4 NAAs group are warranted to confirm a firm ≥5-year interval surveillance colonoscopy.
- All Author(s)
- S. Park
; S. R. Jeon
; H. G. Kim
; Y. Jung
; M. S. Kwak
; S. Y. Kim
; J. W. Kim
; S. J. Nam
; E. H. Oh
; S. Y. Park
; S. K. Park
; J. S. Byeon
; S. J. Boo
; D. H. Baek
; S. M. Yoon
; J. Chun
; J. Lee
; M. Choi
- Issued Date
- 2022
- Type
- Article
- Keyword
- *Adenoma/epidemiology; *Colonic Polyps/epidemiology; Colonoscopy; *Colorectal; Neoplasms/diagnosis/epidemiology; Humans; *Neoplasms, Second Primary/epidemiology; Risk Factors
- Publisher
- American College of Gastroenterology
National Gastroenterological Association
- ISSN
- 0002-9270
- Citation Title
- The American Journal of Gastroenterology
- Citation Volume
- 117
- Citation Number
- 4
- Citation Start Page
- 588
- Citation End Page
- 602
- Language(ISO)
- eng
- DOI
- 10.14309/ajg.0000000000001682
- URI
- http://schca-ir.schmc.ac.kr/handle/2022.oak/1194
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