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Melanosis coli: a contrast effect or an oncogenic effect? A large-scale retrospective cohort study

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Abstract

Background

Melanosis coli is characterized by brown mucosa with pigmentation. Studies have showed an increased adenoma detection rate in melanosis patients, whether it is caused by a contrast effect or an oncogenic effect is still controversial. The detection of serrated polys in melanosis patients remains unknown.

Aims

The study aimed to clarify the correlation of adenoma detection rate with melanosis coli and discuss outcomes in less-experienced endoscopists. Serrated polyp detection rate was also been investigated.

Methods

A total of 2150 patients and 39,630 controls were enrolled. A propensity score matching method was used to balance covariates between the two groups. The detection of polyps, adenomas, serrated polyps, and their features was analyzed.

Results

The polyp detection rate (44.65% vs 41.01%, P = 0.005) and adenoma detection rate (30.34% vs 23.92%, P < 0.001) were significantly higher, and the serrated polyp detection rate (0.93% vs 1.58%, P = 0.033) was significantly lower in melanosis coli. The percentage of low-risk adenomas (44.60% vs 39.16%, P < 0.001) and polyps with 6 to 10 mm in size (20.16% vs 16.21%, P < 0.001) were higher in melanosis coli. The detection of large serrated polyps was lower (0.11% vs 0.41%, P = 0.026) in melanosis coli.

Conclusion

Melanosis coli correlates with an increased adenoma detection rate. The detection of large serrated polyps was lower in melanosis patients. Melanosis coli may not be considered a precancerous lesion.

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Data availability

The datasets underlying the current study will be available by the corresponding author for reasonable request.

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Authors and Affiliations

  1. Nankai University School of Medicine, Nankai University, Tianjin, 300071, China

    Yan Wang & Enqiang Linghu

  2. Department of Gastroenterology, the First Medical Center of PLA General Hospital, Beijing, 100853, China

    Yan Wang, Longsong Li, Xiaotong Niu, Fei Gao, Ningli Chai & Enqiang Linghu

  3. Medical School of Chinese PLA, Beijing, 100853, China

    Xiaotong Niu

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  1. Yan Wang
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  2. Longsong Li
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  3. Xiaotong Niu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection and analysis were performed by Yan Wang, Xiaotong Niu and Fei Gao. The first draft of the manuscript was written by Yan Wang and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Ningli Chai or Enqiang Linghu.

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The study was approved by the Institution Review Board of Chinese PLA General hospital.

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Wang, Y., Li, L., Niu, X. et al. Melanosis coli: a contrast effect or an oncogenic effect? A large-scale retrospective cohort study. Int J Colorectal Dis 38, 63 (2023). https://doi.org/10.1007/s00384-023-04357-1

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