Original ArticlesIncreased risk of colorectal neoplasia in patients with primary sclerosing cholangitis and ulcerative colitis: A meta-analysis☆,☆☆
Section snippets
Data identification and selection
Three investigators (R.M.S., O.S.L., P.A.N.) independently searched the MEDLINE database for citations for January 1985 to December 2001 by using the keywords inflammatory bowel disease, ulcerative colitis, and sclerosing cholangitis. In addition, a manual search was performed with the citations in relevant articles and the proceedings from meetings of the American Gastroenterological Association, the American College of Gastroenterology, and the American Association for the Study of Liver
Study selection
Computer-based and manual bibliographic searches identified 22 pertinent articles.1, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30 Eleven articles that contained 12 studies met the inclusion criteria.1, 4, 5, 6, 7, 8, 9, 10, 11, 13, 23 Eight studies were published as full articles in peer-reviewed journals,1, 5, 6, 7, 8, 9, 10, 23 2 were published in abstract form,4, 11 and 2 studies were published in a single letter to the editor13 in response to the original
Discussion
The present meta-analysis indicates an approximate 4-fold increased risk for CR neoplasia in patients with UC and PSC, compared with those with UC alone. This increased risk does not change appreciably when the presence or absence of carcinoma is the only outcome considered. The inclusion of only high-quality studies is one of the important determinants of the validity of a meta-analysis. In the present synthesis, studies reported in abstract form and as letters to the editor were included
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Supported in part by an American Digestive Health Foundation Outcomes Research Training Award to Dr. Soetikno.
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Reprint requests: Roy M. Soetikno, MD, Gastroenterology Section (111-GI), Palo Alto Veterans Affairs Health Care System, 1801 Miranda Ave., Palo Alto, CA 94304.