Risk of Colorectal Cancer and Cancer Related Mortality After Detection of Low-risk or High-risk Adenomas, Compared With No Adenoma, at Index Colonoscopy: A Systematic Review and Meta-analysis
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View abstract on PubMed
Summary
This summary is machine-generated.The risk of colorectal cancer (CRC) and related mortality is significantly higher for patients with high-risk adenomas (HRAs). However, patients with low-risk adenomas (LRAs) have a very low risk, similar to those with no adenomas.
Area Of Science
- Gastroenterology
- Oncology
- Preventive Medicine
Background
- The risk of developing metachronous colorectal cancer (CRC) after initial colonoscopy varies based on adenoma findings.
- Distinguishing the precise risk associated with no adenomas, low-risk adenomas (LRAs), and high-risk adenomas (HRAs) is crucial for effective patient management.
Purpose Of The Study
- To conduct a systematic review and meta-analysis comparing the incidence of metachronous CRC and CRC-related mortality.
- To evaluate these risks across patient groups defined by adenoma status (none, LRA, HRA) following baseline colonoscopy.
Main Methods
- Systematic search of PubMed, Embase, Google Scholar, and Cochrane databases.
- Meta-analysis of 12 studies including 510,019 patients with a mean follow-up of 8.5 years.
- Primary outcome: incidence of metachronous CRC and CRC-related mortality per 10,000 person-years.
Main Results
- Incidence of CRC was significantly higher in patients with HRAs (13.8/10,000 person-years) compared to no adenomas (3.4) and LRAs (4.5).
- CRC-related mortality was significantly elevated in patients with HRAs versus LRAs and no adenomas.
- No significant difference in CRC-related mortality was observed between patients with LRAs and those with no adenomas.
Conclusions
- Patients with HRAs face a substantially increased risk of metachronous CRC and associated mortality.
- The risk of metachronous CRC and mortality for patients with LRAs is very low and comparable to those with no adenomas.
- Follow-up surveillance for patients with LRAs should align with recommendations for individuals with no adenomas detected during initial colonoscopy.
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