Adenoma characteristics as risk factors for recurrence of advanced adenomas

Martı́nez, Marı́a Elena; Sampliner, Richard E.; Marshall, James R.; Bhattacharyya, Achyut K.; Reid, Mary E.; Alberts, David S.

doi:10.1053/gast.2001.23247

Cited by 224 publications

(170 citation statements)

References 35 publications

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“…The higher luminal pH levels induced by H. pylori infection may also increase the absorption of ammonia, thus contributing to enhanced genetic damage, leading to colorectal carcinogenesis (41). Consistent with several previously conducted studies (10,19,42), in our study, patients who had proximal neoplasia were more likely to develop recurrent neoplasia. Although the underlying mechanisms are uncertain, this finding suggests differences in the tumorigenic process based on the site of the large bowel.…”

Section: Discussionsupporting

confidence: 92%

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Inoue

Kato

Yoshimura

et al. 2012

Molecular and Clinical Oncology

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Abstract.In a previous population-based case-control study, we demonstrated an elevated risk of colorectal neoplasia with Helicobacter pylori (H. pylori) infection. The present study investigated the effects of H. pylori-associated chronic gastritis on the development of colorectal neoplasia by analyzing the recurrence of colorectal neoplasia subsequent to endoscopic resection. Ninety-nine patients who had undergone endoscopic resection of colorectal neoplasia were monitored under colonoscopy, and the recurrence of colorectal neoplasia was prospectively investigated. The stage of H. pylori-associated chronic gastritis in each subject was evaluated using a combination of two serum tests: H. pylori antibody and pepsinogen. In the present cohort, colorectal neoplasia recurred at a rate of 15,296/100,000 person-years during the study period. After adjusting for the confounding factors, chronic atrophic gastritis (CAG) was identified as an independent risk factor [adjusted hazard ratio (HR), 2.72; 95% confidence interval, 1.33-5.57], while H. pylori-infected non-atrophic gastritis was not identified as an independent risk factor for recurrent colorectal neoplasia. Colorectal neoplasia recurred earlier and was significantly more frequent in patients with CAG (22,573/100,000 person-years) compared to patients without CAG (11,089/100,000 person-years; P=0.029, log-rank test).Patients with more extensive CAG showed a higher risk of recurrence. These results demonstrated a significant elevation of the risk of recurrent colorectal neoplasia with the establishment and progression of CAG, indicating the involvement of H. pylori infection in the development of colorectal neoplasia. The two serum tests were useful clinical markers for noninvasively evaluating the risk of each individual for recurrent colorectal neoplasia subsequent to endoscopic resection.

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Section: Discussionsupporting

confidence: 92%

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Inoue

Kato

Yoshimura

et al. 2012

Molecular and Clinical Oncology

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“…Although the pathophysiology of occurrent and recurrent adenomas is likely to overlap, there are some differences, for example, in bowel location propensity. 39 In addition, occurrent adenomas may better capture the effect of earlier dietary intake. Our meta-analysis performed a subgroup analysis to examine occurrent adenomas separately and observed a potential benefit that earlier calcium intake may confer.…”

Section: Discussionmentioning

confidence: 99%

Calcium intake and colorectal adenoma risk: Dose‐response meta‐analysis of prospective observational studies

Keum

Aune

Greenwood

et al. 2014

Intl Journal of Cancer

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Evidence from randomized controlled trials suggests that calcium may protect against recurrence of colorectal adenomas, which could lead to the subsequent prevention of cancer. Yet the trials used only a large single dose and were of small sizes, and thus, knowledge of the dose-response relationship and influence on high-risk adenomas is limited. To address these issues, we conducted linear and nonlinear dose-response meta-analyses primarily based on prospective observational studies published up to July 2014 identified from PubMed and Embase. Summary relative risks (RRs) and 95% confidence intervals (CIs) were calculated for total and supplemental calcium intake, respectively, using a random-effects model. For total calcium intake, summary RR for each 300 mg/day increase was 0.95 (95% CI 5 0.92-0.98; I 2 5 45%; eight studies with 11,005 cases;range of intake 5 333-2,229 mg/day). Evidence of nonlinearity was indicated: approximately, compared to 550 mg/day of total calcium intake, the summary RR was 0.92 (95% CI 5 0.89-0.94) at 1,000 mg/day and 0.87 (95% CI 5 0.84-0.90) at 1,450 mg/day (p nonlinearity < 0.01). Associations were stronger for high-risk adenomas (1 cm in diameter, (tubulo)villous histology, dysplasia, or multiplicity): approximately, compared to 550 mg/day of total calcium intake, the summary RR was 0.77 (95% CI 5 0.74-0.81) at 1,000 mg/day and reduced to 0.69 (95% CI 5 0.66-0.73) at 1,450 mg/da (p nonlinearity < 0.01). For supplemental calcium intake, summary RR of total adenoma risk for each 300 mg/day increase was 0.96 (95% CI 5 0.93-0.99; I 2 5 0%; three studies with 4,548 cases; range of supplementation 5 0-1,366 mg/day). In conclusion, calcium intake may continue to decrease the risk of adenomas, particularly high-risk adenomas, over a wide range of calcium intake.

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“…A maioria dos adenomas tem menos de um centímetro na colonoscopia 8 . A proporção de adenomas, com características histológicas avançadas (displasia de alto grau ou mais de 25% com hitologia vilosa), aumenta cerca de 1 a 2% em adenomas pequenos (<5 mm), de 7 a 12% em adenomas médios (0,5 a 1 cm) e 20 a 30% em adenomas maiores de um centímetro 23 25 . Um terceiro relatório mostrou que os pacientes com apenas 1 ou 2 adenomas tubulares menores do que um centímetro possuíam um baixo risco de neoplasia do cólon, após cinco anos de seguimento.…”

Section: Características Geraisunclassified

Prevalência de adenomas colorretais em pacientes com história familiar para câncer colorretal

Zandoná

Carvalho

Schimedt

et al. 2011

Rev bras. colo-proctol.

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Adenoma characteristics as risk factors for recurrence of advanced adenomas

Cited by 224 publications

References 35 publications

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Elevated risk of recurrent colorectal neoplasia with Helicobacter pylori-associated chronic atrophic gastritis: A follow-up study of patients with endoscopically resected colorectal neoplasia

Calcium intake and colorectal adenoma risk: Dose‐response meta‐analysis of prospective observational studies

Prevalência de adenomas colorretais em pacientes com história familiar para câncer colorretal

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