Colorectal cancer risk high in patient with cryptogenic pyogenic liver abscess

Patients suffering from cryptogenic pyogenic liver abscess (PLA) are at a greater risk of developing colorectal cancer, reports a recent meta-analysis.

After applying the selection criteria, researchers deemed 12 studies to be eligible for meta-analysis. This included a pooled sample of 18,607 PLA patients and 60,130 controls. The sample was mostly male (63 percent) and patients were aged between 56 and 94 years. Studies were retrieved from the databases of Web of Science, LILACS, Scopus, Google Scholar, Embase and Pubmed.

Colorectal cancer occurred almost seven times more frequently in PLA patients than in controls (7.9 percent vs 1.2 percent; p=0.001). The resulting relative risk estimate was 6.6. In majority of the PLA patients, detection of colorectal cancer was performed using colonoscopy. Sensitivity analyses found that no single study had an outsized effect on the estimates.

Heterogeneity of evidence, however, was substantial. The prediction interval for colorectal cancer was 1.3–35.5, with an I² value of 92.4.

The funnel plot also suggested the presence of publication bias, as confirmed by the Egger regression test (p=0.01). Adjustments for the biased studies, however, did not meaningfully affect the pooled estimates.

“Although limited by heterogeneity, our results seem to support the need for a screening colonoscopy in patients diagnosed with cryptogenic PLA, especially if positive for Klebsiella pneumoniae,” said researchers.