Observational Study
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2024; 16(1): 133-143
Published online Jan 15, 2024. doi: 10.4251/wjgo.v16.i1.133
Colonoscopy plays an important role in detecting colorectal neoplasms in patients with gastric neoplasms
Xu-Rui Liu, Ze-Lin Wen, Fei Liu, Zi-Wei Li, Xiao-Yu Liu, Wei Zhang, Dong Peng
Xu-Rui Liu, Fei Liu, Zi-Wei Li, Xiao-Yu Liu, Wei Zhang, Dong Peng, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China
Ze-Lin Wen, Department of Gastrointestinal Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, China
Co-first authors: Xu-Rui Liu and Ze-Lin Wen.
Author contributions: Peng D conceived, designed and refined the study protocol; Liu XR and Wen ZL were involved in the data collection; Liu XR and Wen ZL analyzed the data; Liu XR and Wen ZL drafted the manuscript; All authors were involved in the critical review of the results and have contributed to, read, and approved the final manuscript. Liu XR and Wen ZL contributed equally to this work as co-first authors. The reasons for designating Liu XR and Wen ZL as co-first authors are threefold. First, the research was performed as a collaborative effort, and the designation of co-first authorship accurately reflects the distribution of responsibilities and burdens associated with the time and effort required to complete the study and the resultant paper. This also ensures effective communication and management of post-submission matters, ultimately enhancing the paper's quality and reliability. Second, the overall research team encompassed authors with a variety of expertise and skills from different fields, and the designation of co-first authors best reflects this diversity. This also promotes the most comprehensive and in-depth examination of the research topic, ultimately enriching readers' understanding by offering various expert perspectives. Third, Liu XR and Wen ZL contributed efforts of equal substance throughout the research process. The choice of these researchers as co-first authors acknowledges and respects this equal contribution, while recognizing the spirit of teamwork and collaboration of this study. In summary, we believe that designating Liu XR and Wen ZL as co-first authors of is fitting for our manuscript as it accurately reflects our team's collaborative spirit, equal contributions, and diversity.
Supported by CQMU Program for Youth Innovation in Future Medicine, No. W0190.
Institutional review board statement: The data used in this study were obtained from public databases. No Institutional Review board Approval were needed.
Informed consent statement: The data was accessed in the database and all patients sighed informed consent.
Conflict-of-interest statement: The authors declare that there are no conflicts of interests.
Data sharing statement: The data was accessed in the database.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong Peng, PhD, Doctor, Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, No.1 Youyi Road, Yuanjiagang, Yuzhong District, Chongqing 400016, China. carry_dong@126.com
Received: October 3, 2023
Peer-review started: October 3, 2023
First decision: October 8, 2023
Revised: October 14, 2023
Accepted: December 4, 2023
Article in press: December 4, 2023
Published online: January 15, 2024
Processing time: 99 Days and 11.7 Hours
Abstract
BACKGROUND

Gastric cancer (GC) and colorectal cancer (CRC) are the fifth and third most common cancer worldwide, respectively. Nowadays, GC is reported to have a potential predictive value for CRC, especially for advanced CRC.

AIM

To evaluate the necessity of colonoscopy for gastric neoplasm (GN) patients.

METHODS

Four databases, including PubMed, EMBASE, the Cochrane Library, and Ovid, were used to perform the search strategy on May 2, 2023. The prevalence of colorectal neoplasms (CRN) and baseline characteristics were compared between the neoplasm group and the control group. Continuous variables are expressed as the mean difference and standard deviation. Relationships of categorical variables in the two groups are expressed as odds ratios (OR) and 95% confidence intervals (95%CIs). Subgroup analysis according to different kinds of GNs was conducted for more in-depth analysis. The results of this study are represented by forest plots. Publication bias was evaluated by a funnel plot. All data analyses were performed by STATA SE 16.0 software.

RESULTS

A total of 3018 patients with GNs and 3905 healthy controls (age and sex matched) were enrolled for analysis. After comparing the prevalence of CRNs between the two groups, CRNs were detected significantly more frequently in GN patients than in controls (OR = 1.69, 95%CI = 1.28 to 2.23, I2 = 85.12%, P = 0.00), especially in patients with GC (OR =1.80, 95%CI = 1.49 to 2.18, I2 = 25.55%, P < 0.1). Moreover, other risk factors including age (OR = 1.08, 95%CI = 1.00 to 1.17, I2 = 90.13%, P = 0.00) and male sex (OR = 2.31, 95%CI = 1.26 to 4.22, I2 = 87.35%, P = 0.00), were related to the prevalence of CRNs. For patients in the GN group, body mass index (BMI, OR = 0.88, 95%CI = 0.80 to 0.98, I2 = 0.00%, P = 0.92) and smoking (OR = 1.03, 95%CI = 1.01 to 1.05, I2 = 0.00%, P = 0.57) were protective and risk factors for CRNs, respectively.

CONCLUSION

Patients are recommended to undergo colonoscopy when diagnosed with GNs, especially GC patients with a low BMI and a history of smoking.

Keywords: Gastric neoplasm, Gastric cancer, Colorectal neoplasm, Colonoscopy

Core Tip: Gastric cancer (GC) is currently the fifth largest malignant tumor worldwide and the second largest cause of cancer-related deaths in the world. Synchronous and homologous neoplasms are common in gastric neoplasm (GN) patients, and the colorectal neoplasm (CRN) is the main neoplasm type. The prevalence of CRN in GN patients is a concern. Some studies reported that GN was not a risk factor for CRN. Therefore, the purpose of this pooling up analysis was to explore whether colonoscopy was needed for GN patients to detecting CRN. A total of ten case-control studies were included, involving 6923 patients. In conclusion, GN patients had higher risk of CRN, especially for GC patients. Therefore, colonoscopy was recommended when patients diagnosed with GN.