Endoscopy 2021; 53(S 01): S95
DOI: 10.1055/s-0041-1724498
Abstracts | ESGE Days
ESGE Days 2021 Oral presentations
Saturday, 27 March 2021 17:00 – 17:45 Colonoscopy for screening or surveillance Room 6

Risk of Colorectal Cancer After Detection of Low-Risk or High-Risk Adenomas, Compared with no Adenoma, at Screening Colonoscopy: a Systematic Review and Meta-Analysis

G Antonelli
1   Nuovo Regina Margherita Hospital, Digestive Endoscopy Unit, Rome, Italy
2   Department of Translational and Precision Medicine, Sapienza University of Rome, Rome, Italy
,
A Duvvuri
3   Department of Gastroenterology and Digestive Endoscopy, Kansas City, University of Kansas Medical Center, United States
,
V Thoguluva Chandrasekar
3   Department of Gastroenterology and Digestive Endoscopy, Kansas City, University of Kansas Medical Center, United States
,
M Spadaccini
4   Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Milan, Italy
,
A Repici
4   Humanitas Clinical and Research Center – IRCCS, Endoscopy Unit, Milan, Italy
,
C Hassan
1   Nuovo Regina Margherita Hospital, Digestive Endoscopy Unit, Rome, Italy
,
P Sharma
5   Department of Gastroenterology and Digestive Endoscopy, University of Kansas Medical Center, Kansas CIty, United States
› Author Affiliations
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    Aims The risk of metachronous colorectal cancer (CRC) among patients with no adenomas, low-risk adenomas (LRAs), or high-risk adenomas (HRAs), detected at index screening colonoscopy, is unclear. We performed a systematic review and meta-analysis to compare incidence rates of metachronous CRC and CRC-related mortality after a baseline colonoscopy for each group.

    Methods We searched the Pubmed, EMBASE, Google scholar, and Cochrane databases for studies that reported the incidence of CRC and adenoma characteristics after colonoscopy. The primary outcome was odds of metachronous CRC and CRC-related mortality per 10,000 person-years of follow-up after baseline colonoscopy for all the groups.

    Results Our final analysis included 12 studies with 510,019 patients (mean age, 59.2 ± 2.6 years; 55 % male; mean duration of follow up, 8.5 ± 3.3 years). The incidence of CRC per 10,000 person-years was significantly higher among persons with LRAs compared to persons with no adenomas (4.5 vs 3.4; odds ratio [OR], 1.26; 95 % CI, 1.06–1.51; I2=0), and persons with HRAs compared to persons with LRAs (13.81 vs 4.5; OR, 2.35; 95 % CI, 1.72–3.20; I2=55 %). The CRC related mortality per 10,000 person-years did not differ significantly for persons with LRAs compared to persons with no adenomas (0.78 vs 0.71; OR, 1.15; 95 % CI, 0.76–1.74; I2=0) but was significantly higher in persons with HRAs compared with LRAs (2.07 vs 0.78; OR, 2.48; 95 % CI, 1.30–4.72; I2=38 %).

    Conclusions In a systematic review and meta-analysis, we found the risk of metachronous CRC and mortality to be significantly higher for persons with HRAs, and only marginally higher in patients with LRAs, with no difference in mortality, compared to persons with no adenomas, in screening colonoscopies. Follow up of patients with LRAs detected in an initial colonoscopy should be the same as for persons with no adenomas.

    Citation: Antonelli G, Duvvuri A, Thoguluva Chandrasekar V et al. OP234 RISK OF COLORECTAL CANCER AFTER DETECTION OF LOW-RISK OR HIGH-RISK ADENOMAS, COMPARED WITH NO ADENOMA, AT SCREENING COLONOSCOPY: A SYSTEMATIC REVIEW AND META-ANALYSIS. Endoscopy 2021; 53: S95.


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    Publication History

    Article published online:
    19 March 2021

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