Risk factors and prediction model for post-polypectomy metachronous colorectal adenoma

Area of Science:

• Gastroenterology
• Oncology
• Medical Informatics

Background:

• Endoscopic resection of colorectal adenomas is crucial for reducing cancer mortality.
• Metachronous adenomas post-polypectomy can compromise colonoscopy surveillance effectiveness.

Purpose of the Study:

• To identify risk factors for post-polypectomy metachronous colorectal adenomas.
• To develop and validate a predictive model for metachronous adenoma risk.

Main Methods:

• Retrospective cohort study of 523 patients undergoing colonoscopy.
• LASSO and multivariable Cox regression analyses to identify risk factors.
• Development and validation of a nomogram-based risk prediction model with C-index, td-ROC, calibration curves, and DCA.

Main Results:

• Seven key risk factors identified: age, gender, adenoma size, grade, location, hypertension history, and LDL level.
• The predictive model demonstrated good accuracy (C-index 0.729 training, 0.724 validation) and clinical utility.
• An online webserver was created for practical clinical application.

Conclusions:

• A reliable risk prediction model for post-polypectomy metachronous adenomas was established.
• The model accurately stratifies patient risk, aiding in personalized surveillance.
• Identified risk factors and the predictive tool enhance colorectal cancer prevention strategies.