OBJECTIVES: We conducted a systematic review and meta-analysis of the risk of advanced adenomas (AAs), colorectal cancer (CRC), and/or CRC-related death among individuals with low-risk adenomas (LRAs). METHODS: We searched PubMed and Embase for studies published between January 2006 and July 2015. Quality and strength of the evidence were rated using the Newcastle-Ottawa Scale (NOS) and the GRADE framework, respectively. RESULTS: Eleven observational studies (n=64,317) were included. A meta-analysis of eight cohort studies (n=10,139, 3 to 10 years' follow-up) showed a small but statistically significant increase in the incidence of AAs in individuals with LRAs compared with those with a normal baseline colonoscopy (RR 1.55 (95% CI 1.24-1.94); P=0.0001; I2=0%). The pooled 5-year cumulative incidence of AA was 3.28% (95% CI: 1.85-5.10%), 4.9% (95% CI: 3.18-6.97%), and 17.13% (95% CI: 11.97-23.0%) for the no adenoma, LRA, and AA baseline groups, respectively. Two studies, which could not be pooled, showed a reduction in the risk of CRC in individuals with LRAs compared with the general population (standardized incidence ratio 0.68 (95% CI 0.44-0.99) at a median follow-up of 7.7 years and OR 0.4 (95% CI 0.2-0.6) at 3-5 years). One large retrospective cohort study found a 25% reduction in CRC mortality in individuals with LRAs compared with the general population (SMR 0.75 (95% CI 0.63-0.88) at a median follow-up of 7.7 years). CONCLUSIONS: We observed a small but significant increase in the risk of AAs in people with LRAs compared with those with a normal baseline colonoscopy, but compared with the general population, people with LRAs have significantly lower risks of CRC and of CRC-related mortality.
OBJECTIVES: We conducted a systematic review and meta-analysis of the risk of advanced adenomas (AAs), colorectal cancer (CRC), and/or CRC-related death among individuals with low-risk adenomas (LRAs). METHODS: We searched PubMed and Embase for studies published between January 2006 and July 2015. Quality and strength of the evidence were rated using the Newcastle-Ottawa Scale (NOS) and the GRADE framework, respectively. RESULTS: Eleven observational studies (n=64,317) were included. A meta-analysis of eight cohort studies (n=10,139, 3 to 10 years' follow-up) showed a small but statistically significant increase in the incidence of AAs in individuals with LRAs compared with those with a normal baseline colonoscopy (RR 1.55 (95% CI 1.24-1.94); P=0.0001; I2=0%). The pooled 5-year cumulative incidence of AA was 3.28% (95% CI: 1.85-5.10%), 4.9% (95% CI: 3.18-6.97%), and 17.13% (95% CI: 11.97-23.0%) for the no adenoma, LRA, and AA baseline groups, respectively. Two studies, which could not be pooled, showed a reduction in the risk of CRC in individuals with LRAs compared with the general population (standardized incidence ratio 0.68 (95% CI 0.44-0.99) at a median follow-up of 7.7 years and OR 0.4 (95% CI 0.2-0.6) at 3-5 years). One large retrospective cohort study found a 25% reduction in CRC mortality in individuals with LRAs compared with the general population (SMR 0.75 (95% CI 0.63-0.88) at a median follow-up of 7.7 years). CONCLUSIONS: We observed a small but significant increase in the risk of AAs in people with LRAs compared with those with a normal baseline colonoscopy, but compared with the general population, people with LRAs have significantly lower risks of CRC and of CRC-related mortality.
Authors: Stuart R Cairns; John H Scholefield; Robert J Steele; Malcolm G Dunlop; Huw J W Thomas; Gareth D Evans; Jayne A Eaden; Matthew D Rutter; Wendy P Atkin; Brian P Saunders; Anneke Lucassen; Paul Jenkins; Peter D Fairclough; Christopher R J Woodhouse Journal: Gut Date: 2010-05 Impact factor: 23.059
Authors: Su Jin Chung; Young Sun Kim; Sun Young Yang; Ji Hyun Song; Donghee Kim; Min Jung Park; Sang Gyun Kim; In Sung Song; Joo Sung Kim Journal: Gut Date: 2011-03-22 Impact factor: 23.059
Authors: Gordon H Guyatt; Andrew D Oxman; Gunn E Vist; Regina Kunz; Yngve Falck-Ytter; Pablo Alonso-Coello; Holger J Schünemann Journal: BMJ Date: 2008-04-26
Authors: Wai K Leung; James Yw Lau; Bing Yee Suen; Grace Lh Wong; Dorothy Kl Chow; Larry H Lai; Ka-Fai To; Carmen Km Yim; Envy Sf Lee; Kelvin Kf Tsoi; Simon Sm Ng; Joseph Jy Sung Journal: Am J Gastroenterol Date: 2009-05-19 Impact factor: 10.864
Authors: Chun-Han Lo; Long H Nguyen; Kana Wu; Shuji Ogino; Andrew T Chan; Edward L Giovannucci; Mingyang Song Journal: Cancer Prev Res (Phila) Date: 2020-08
Authors: Reinier G S Meester; Iris Lansdorp-Vogelaar; Sidney J Winawer; Ann G Zauber; Amy B Knudsen; Uri Ladabaum Journal: Ann Intern Med Date: 2019-09-24 Impact factor: 25.391
Authors: Samir Gupta; David Lieberman; Joseph C Anderson; Carol A Burke; Jason A Dominitz; Tonya Kaltenbach; Douglas J Robertson; Aasma Shaukat; Sapna Syngal; Douglas K Rex Journal: Gastroenterology Date: 2020-02-07 Impact factor: 22.682
Authors: Samir Gupta; David Lieberman; Joseph C Anderson; Carol A Burke; Jason A Dominitz; Tonya Kaltenbach; Douglas J Robertson; Aasma Shaukat; Sapna Syngal; Douglas K Rex Journal: Gastrointest Endosc Date: 2020-02-07 Impact factor: 9.427
Authors: Samir Gupta; David Lieberman; Joseph C Anderson; Carol A Burke; Jason A Dominitz; Tonya Kaltenbach; Douglas J Robertson; Aasma Shaukat; Sapna Syngal; Douglas K Rex Journal: Am J Gastroenterol Date: 2020-03 Impact factor: 12.045