Published online Jan 15, 2022. doi: 10.4251/wjgo.v14.i1.348
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
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.
Whether the risk of CRN in IBD patients with PIPs is increased will have a significant impact on the surveillance strategies of IBD patients.
The current study aimed to evaluate the risk of CRN in IBD patients with and without PIPs.
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.
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).
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.
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.