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Chronic Viral Hepatitis Is Associated with Colorectal Neoplasia: A Systematic Review and Meta-Analysis

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Abstract

Background

Chronic viral hepatitis is associated with a wide range of extrahepatic diseases; however, evidence on a link between chronic viral hepatitis and colorectal neoplasia is still lacking.

Aims

To analyze the association between chronic viral hepatitis and prevalence of colorectal neoplasia.

Methods

A systematic review of articles published in the MEDLINE, EMBASE, and Cochrane Library between 2000 and 2020 was performed. Subgroup analyses based on the types of colorectal neoplasia and the etiology of chronic viral hepatitis were conducted.

Results

Twelve eligible studies with 48,428 hepatitis B virus (HBV) patients and 46,561 hepatitis C virus (HCV) patients were included. Chronic viral hepatitis was significantly associated with an increased risk of both colorectal adenoma (odds ratio [OR], 1.53; 95% confidence interval [CI], 1.16–2.02; I2 = 83%) and colorectal cancer (CRC) (OR, 1.32; 95% CI, 1.08–1.61; I2 = 94%). The etiology of chronic viral hepatitis was an independent factor related to heterogeneity for CRC subgroup analysis revealed an increased risk of CRC in both HBV (OR, 1.18; 95% CI, 1.09–1.27; I2 = 37%) and HCV (OR, 1.88; 95% CI, 1.78–1.97; I2 = 0%). HCV was associated with an increased risk of colorectal adenoma (OR, 1.48; 95% CI, 1.22–1.79; I2 = 0%); however, HBV was not associated with an increased risk of colorectal adenoma and had considerable heterogeneity (OR, 1.65; 95% CI, 0.88–3.09; I2 = 90%).

Conclusion

Our meta-analysis showed that chronic viral hepatitis is associated with an increased risk of colorectal neoplasia. The strategy of stricter screening colonoscopy may benefit from patients with chronic viral hepatitis.

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Abbreviations

APC:

Adenomatous polyposis coli

CI:

Confidence interval

CRA:

Colorectal adenoma

CRC:

Colorectal carcinoma

HBV:

Hepatitis B virus

HCV:

Hepatitis C virus

OR:

Odds ratio

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Funding

There was no funding or support for this study. Interpretation and reporting of the data were the sole responsibility of the authors. No other disclosures are declared.

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Author notes

  1. Seung Wook Hong and Won-Mook Choi have contributed equally to this work.

Authors and Affiliations

  1. Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, Republic of Korea

    Seung Wook Hong, Won-Mook Choi, Ha Won Hwang, Dae Sung Kim, Jiyoung Yoon, Jin Wook Lee, Ju Hyun Shim, Dong-Hoon Yang, Seung-Jae Myung, Suk-Kyun Yang & Jeong-Sik Byeon

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  1. Seung Wook Hong
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Contributions

All authors have full access to all data used in the study and take responsibility for the integrity of the data and the accuracy of the data analysis. All authors were responsible for the design of the study, the acquisition, analysis and interpretation of the data, and drafting of the manuscript. WMC performed statistical analyses. SWH, WMC, and JSB contributed to data analysis, interpretation, and drafting of the manuscript and critically revised important intellectual content within the manuscript. All authors approved the final version for submission.

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Correspondence to Jeong-Sik Byeon.

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Hong, S.W., Choi, WM., Hwang, H.W. et al. Chronic Viral Hepatitis Is Associated with Colorectal Neoplasia: A Systematic Review and Meta-Analysis. Dig Dis Sci 66, 3715–3724 (2021). https://doi.org/10.1007/s10620-020-06745-x

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  • DOI: https://doi.org/10.1007/s10620-020-06745-x

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