Colonoscopy and Risk of Colorectal Cancer in Patients With Nonalcoholic Fatty Liver Disease: A Retrospective Territory‐Wide Cohort Study
The benefit of colonoscopy and/or polypectomy for colorectal cancer (CRC) prevention in patients with nonalcoholic fatty liver disease (NAFLD) remains unclear. We aimed to estimate the incidence rate of CRC in patients with NAFLD who had and had not undergone colonoscopy. We conducted a retrospectiv...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Health/LWW
2021-07-01
|
| Series: | Hepatology Communications |
| Online Access: | https://doi.org/10.1002/hep4.1705 |
| _version_ | 1797935535046524928 |
|---|---|
| author | Xinrong Zhang Vincent Wai‐Sun Wong Terry Cheuk‐Fung Yip Yee‐Kit Tse Lilian Yan Liang Vicki Wing‐Ki Hui Guan‐Lin Li Henry Lik‐Yuen Chan Grace Lai‐Hung Wong |
| author_facet | Xinrong Zhang Vincent Wai‐Sun Wong Terry Cheuk‐Fung Yip Yee‐Kit Tse Lilian Yan Liang Vicki Wing‐Ki Hui Guan‐Lin Li Henry Lik‐Yuen Chan Grace Lai‐Hung Wong |
| author_sort | Xinrong Zhang |
| collection | DOAJ |
| description | The benefit of colonoscopy and/or polypectomy for colorectal cancer (CRC) prevention in patients with nonalcoholic fatty liver disease (NAFLD) remains unclear. We aimed to estimate the incidence rate of CRC in patients with NAFLD who had and had not undergone colonoscopy. We conducted a retrospective territory‐wide cohort study for patients aged over 40 years with NAFLD identified with the International Classification of Diseases, Ninth Revision, Clinical Modification codes between January 1, 2000, and December 31, 2014. Patients were followed until CRC diagnosis, death, or December 31, 2017. We estimated CRC incidence and standardized incidence ratio (SIR) using the general population of Hong Kong as reference. We included 8,351 patients with NAFLD in the final analysis (median age, 56.2 years; interquartile ratio [IQR], 49.2‐65.3 years; 45.4% male; median follow‐up, 7.4 years; IQR, 5.4‐9.6 years). Compared with the general population, patients with NAFLD who had not undergone colonoscopy had a higher incidence of CRC (SIR, 2.20; 95% confidence interval [CI], 1.64‐2.88; P < 0.001). Patients with NAFLD who had undergone colonoscopy had a lower incidence of CRC (SIR, 0.54; 95% CI, 0.37‐0.75; P < 0.001), especially among those aged above 50 years or with diabetes mellitus (DM). Patients with NAFLD with a high fibrosis‐4 (FIB‐4) score (>2.67) had a significantly higher risk of CRC after adjusting for demographic and metabolic factors. Conclusion: Patients with NAFLD who had undergone colonoscopy had a lower incidence of CRC than the general population, especially among those aged ≥50 years or with DM. A high FIB‐4 index was associated with a higher risk of CRC. |
| first_indexed | 2024-04-10T18:15:49Z |
| format | Article |
| id | doaj.art-5237d7d01c484782bb350f1a797b1f14 |
| institution | Directory Open Access Journal |
| issn | 2471-254X |
| language | English |
| last_indexed | 2024-04-10T18:15:49Z |
| publishDate | 2021-07-01 |
| publisher | Wolters Kluwer Health/LWW |
| record_format | Article |
| series | Hepatology Communications |
| spelling | doaj.art-5237d7d01c484782bb350f1a797b1f142023-02-02T08:42:09ZengWolters Kluwer Health/LWWHepatology Communications2471-254X2021-07-01571212122310.1002/hep4.1705Colonoscopy and Risk of Colorectal Cancer in Patients With Nonalcoholic Fatty Liver Disease: A Retrospective Territory‐Wide Cohort StudyXinrong Zhang0Vincent Wai‐Sun Wong1Terry Cheuk‐Fung Yip2Yee‐Kit Tse3Lilian Yan Liang4Vicki Wing‐Ki Hui5Guan‐Lin Li6Henry Lik‐Yuen Chan7Grace Lai‐Hung Wong8Department of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaDepartment of Medicine and Therapeutics The Chinese University of Hong Kong Hong Kong ChinaThe benefit of colonoscopy and/or polypectomy for colorectal cancer (CRC) prevention in patients with nonalcoholic fatty liver disease (NAFLD) remains unclear. We aimed to estimate the incidence rate of CRC in patients with NAFLD who had and had not undergone colonoscopy. We conducted a retrospective territory‐wide cohort study for patients aged over 40 years with NAFLD identified with the International Classification of Diseases, Ninth Revision, Clinical Modification codes between January 1, 2000, and December 31, 2014. Patients were followed until CRC diagnosis, death, or December 31, 2017. We estimated CRC incidence and standardized incidence ratio (SIR) using the general population of Hong Kong as reference. We included 8,351 patients with NAFLD in the final analysis (median age, 56.2 years; interquartile ratio [IQR], 49.2‐65.3 years; 45.4% male; median follow‐up, 7.4 years; IQR, 5.4‐9.6 years). Compared with the general population, patients with NAFLD who had not undergone colonoscopy had a higher incidence of CRC (SIR, 2.20; 95% confidence interval [CI], 1.64‐2.88; P < 0.001). Patients with NAFLD who had undergone colonoscopy had a lower incidence of CRC (SIR, 0.54; 95% CI, 0.37‐0.75; P < 0.001), especially among those aged above 50 years or with diabetes mellitus (DM). Patients with NAFLD with a high fibrosis‐4 (FIB‐4) score (>2.67) had a significantly higher risk of CRC after adjusting for demographic and metabolic factors. Conclusion: Patients with NAFLD who had undergone colonoscopy had a lower incidence of CRC than the general population, especially among those aged ≥50 years or with DM. A high FIB‐4 index was associated with a higher risk of CRC.https://doi.org/10.1002/hep4.1705 |
| spellingShingle | Xinrong Zhang Vincent Wai‐Sun Wong Terry Cheuk‐Fung Yip Yee‐Kit Tse Lilian Yan Liang Vicki Wing‐Ki Hui Guan‐Lin Li Henry Lik‐Yuen Chan Grace Lai‐Hung Wong Colonoscopy and Risk of Colorectal Cancer in Patients With Nonalcoholic Fatty Liver Disease: A Retrospective Territory‐Wide Cohort Study Hepatology Communications |
| title | Colonoscopy and Risk of Colorectal Cancer in Patients With Nonalcoholic Fatty Liver Disease: A Retrospective Territory‐Wide Cohort Study |
| title_full | Colonoscopy and Risk of Colorectal Cancer in Patients With Nonalcoholic Fatty Liver Disease: A Retrospective Territory‐Wide Cohort Study |
| title_fullStr | Colonoscopy and Risk of Colorectal Cancer in Patients With Nonalcoholic Fatty Liver Disease: A Retrospective Territory‐Wide Cohort Study |
| title_full_unstemmed | Colonoscopy and Risk of Colorectal Cancer in Patients With Nonalcoholic Fatty Liver Disease: A Retrospective Territory‐Wide Cohort Study |
| title_short | Colonoscopy and Risk of Colorectal Cancer in Patients With Nonalcoholic Fatty Liver Disease: A Retrospective Territory‐Wide Cohort Study |
| title_sort | colonoscopy and risk of colorectal cancer in patients with nonalcoholic fatty liver disease a retrospective territory wide cohort study |
| url | https://doi.org/10.1002/hep4.1705 |
| work_keys_str_mv | AT xinrongzhang colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy AT vincentwaisunwong colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy AT terrycheukfungyip colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy AT yeekittse colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy AT lilianyanliang colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy AT vickiwingkihui colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy AT guanlinli colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy AT henrylikyuenchan colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy AT gracelaihungwong colonoscopyandriskofcolorectalcancerinpatientswithnonalcoholicfattyliverdiseasearetrospectiveterritorywidecohortstudy |