Meta-Analysis
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Jan 15, 2022; 14(1): 348-361
Published online Jan 15, 2022. doi: 10.4251/wjgo.v14.i1.348
Increased risk of colorectal neoplasia in inflammatory bowel disease patients with post-inflammatory polyps: A systematic review and meta-analysis
De-Gao He, Xi-Jie Chen, Juan-Ni Huang, Jun-Guo Chen, Min-Yi Lv, Tian-Ze Huang, Ping Lan, Xiao-Sheng He
De-Gao He, Xi-Jie Chen, Jun-Guo Chen, Min-Yi Lv, Tian-Ze Huang, Ping Lan, Xiao-Sheng He, Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, Guangzhou 510655, Guangdong Province, China
Juan-Ni Huang, Department of Geriatrics, the first Affiliated Hospital, Guangzhou Medical University, Guangzhou 510120, Guangdong Province, China
Author contributions: He DG, Chen XJ and Huang JN contributed equally to this work; He DG, Chen XJ and He XS designed study; He DG, Chen XJ, performed literature search and review, He DG, Chen XJ, Huang JN, Chen JG, Lv MY and Huang TZ collected data; He DG, Chen XJ, Huang JN and He XS wrote and edited the manuscript; He DG and Lan P did statistical analysis; He DG, Chen XJ, Huang JN, Chen JG, Lv MY and Huang TZ contributed to methodological quality assessment; Lan P and He XS reviewed manuscript; All authors have read and approved the final manuscript.
Supported by The National Key R&D Program of China, No. 2017YFC1308800; National Natural Science Foundation of China, No. 81970482; Natural Science Foundation of Guangdong Province, China, No. 2019A1515011313; Sun Yat-Sen University 5010 Project, No. 2010012; and the Fundamental Research Funds for the Central Universities, No. 19ykpy05, and National Key Clinical Discipline.
Conflict-of-interest statement: Authors have no conflicts of interest to declare.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
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: Xiao-Sheng He, MD, PhD, Doctor, Department of Colorectal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangdong Institute of Gastroenterology, Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Diseases, No. 26 Yuancun Er Heng Road, Guangzhou 510655, Guangdong Province, China. hexsheng@mail.sysu.edu.cn
Received: August 6, 2021
Peer-review started: August 6, 2021
First decision: August 29, 2021
Revised: September 8, 2021
Accepted: November 24, 2021
Article in press: November 24, 2021
Published online: January 15, 2022
Processing time: 157 Days and 6.3 Hours
ARTICLE HIGHLIGHTS
Research background

Inflammatory bowel disease (IBD) patients with post-inflammatory polyps (PIPs) may carry an increased risk of colorectal neoplasia (CRN). Current guidelines recommend more aggressive colonoscopy follow-up in these patients. However, the guidelines are based on a low degree of evidence and several recent high-quality studies have shown that the presence of PIPs is not an independent risk factor for CRN in IBD patients.

Research motivation

Whether the risk of CRN in IBD patients with PIPs is increased will have a significant impact on the surveillance strategies of IBD patients.

Research objectives

The current study aimed to evaluate the risk of CRN in IBD patients with and without PIPs.

Research methods

A systematic literature search was performed to identify studies that compared the risk of CRN in IBD patients with and without PIPs. Pooled odds ratio (OR) was calculated using the random-effects model to explore the final pooled effect size of the included studies and determine whether PIPs increase the risk of CRN. Sensitivity analysis, subgroup analysis, and assessment of publication bias were performed to determine the sources of heterogeneity.

Research results

We found that IBD patients with PIPs had an approximately 2-fold increased risk of CRN [OR 2.01; 95% confidence interval (CI): 1.43–2.83]. The results were similar when colorectal cancer was used as the study endpoint (OR 2.57; 95%CI: 1.69–3.91).

Research conclusions

IBD patients with PIPs have a higher risk of CRN than those without PIPs, which support current guidelines that IBD patients with PIPs require more frequent surveillance.

Research perspectives

Our findings not only confirm the viewpoint of the guidelines, but may also improve the degree of evidence. We expect that our study can provide a reference for the development of surveillance strategies for IBD patients.