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Risk factors for metachronous colorectal cancer or polyp: A systematic review and meta‐analysis
Author(s) -
Jayasekara Harindra,
Reece Jeanette C,
Buchanan Daniel D,
Ahnen Dennis J,
Parry Susan,
Jenkins Mark A,
Win Aung Ko
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13476
Subject(s) - medicine , relative risk , meta analysis , colorectal cancer , confidence interval , colonoscopy , gastroenterology , risk factor , cancer
Background and Aim We conducted a systematic review and meta‐analysis to identify personal, lifestyle, and tumor‐related risk factors for metachronous colorectal cancer (CRC) and polyp. Methods Relevant studies were identified by searching MEDLINE, Web of Science and Cochrane Central Register through 15 May 2016. Estimates for associations were summarized using random effects models. Results Fifty‐five studies were included in the review. For individuals who had a CRC resection, having a synchronous polyp was a risk factor for metachronous CRC or polyp (relative risk [RR], 2.04; 95% confidence interval [CI], 1.48–2.82) and having a synchronous CRC (RR, 1.90; 95% CI, 1.25–2.91) and proximally located CRC (RR, 2.12; 95% CI, 1.24–3.64) were risk factors for metachronous CRC. For individuals who had a polypectomy, larger size (RR, 4.26; 95% CI, 2.11–8.57) or severe dysplasia of the initial polyp (RR, 5.15; 95% CI, 2.02–13.14), and having a synchronous polyp (RR, 2.52; 95% CI, 1.35–4.73) were risk factors for metachronous CRC; and a family history of CRC (RR, 1.90; 95% CI, 1.26–2.87), having a synchronous polyp (RR, 2.47; 95% CI, 1.74–3.50) and a larger size (RR, 1.49; 95% CI, 1.03–2.15) and proximal location of the initial polyp (RR, 1.20; 95% CI, 1.02–1.40) were risk factors for metachronous polyp. Meta‐regression showed duration of follow‐up was not a source of heterogeneity for most associations. There was no evidence that lifestyle factors were associated with metachronous CRC or polyp risk. Conclusion A comprehensive list of risk factors identified for metachronous CRC or polyp may have important clinical implications.