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Proximal Location as a Predictor of Metachronous Colorectal Cancer After Excision of Adenomas
Sandra Baile-Maxía1, Carolina Mangas-Sanjuán1, Uri Ladabaum2
1Gastroenterology Department, Hospital General Universitario Dr. Balmis. Instituto de Investigación Biomédica ISABIAL, Universidad Miguel Hernández, Alicante, Spain.
Introduction:
To compare metachronous colorectal cancer (CRC) and advanced adenoma (AA) risk in patients with proximal vs. distal adenomas.
Methods:
We searched Pubmed, Embase, and Cochrane for cohort studies and clinical trials. Proximal adenomas were those located proximal to the descending colon. Pooled incidence rate ratios and 95% confidence intervals (CI) for CRC and AA were calculated using a random-effects model.
Results:
Compared with patients with only distal adenomas, patients with any proximal adenoma had a higher risk of metachronous CRC (1.70, 95% CI 1.17-2.45), proximal CRC (3.65, 95% CI 1.57-8.46), and AA (1.82, 95% CI 1.41-2.34).
Discussion:
Baseline adenoma proximal location is associated with future detection of CRC and AA.
