{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T19:52:09Z","timestamp":1791229929922,"version":"4.1.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,9,4]],"date-time":"2024-09-04T00:00:00Z","timestamp":1725408000000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Metachronous colorectal cancer refers to patients developing a second colorectal neoplasia diagnosed at least 6 months after the initial cancer diagnosis, excluding recurrence. The aim of this systematic review is to assess the incidence of metachronous colorectal cancer in early-onset colorectal cancer (defined as age at diagnosis of less than 50 years) and to identify risk factors.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This is a systematic review and meta-analysis performed following the PRISMA statement and registered on PROSPERO. The literature search was conducted in PubMed and Embase. Only studies involving patients with early-onset colorectal cancer (less than 50 years old) providing data on metachronous colorectal cancer were included in the analysis. The primary endpoint was the risk of metachronous colorectal cancer in patients with early-onset colorectal cancer. Secondary endpoints were association with Lynch syndrome, family history and microsatellite instability.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Sixteen studies met the inclusion criteria. The incidence of metachronous colorectal cancer was 2.6% (95% c.i. 2.287\u20133.007). The risk of developing metachronous colorectal cancer in early-onset colorectal cancer versus non-early-onset colorectal cancer patients demonstrated an OR of 0.93 (95% c.i. 0.760\u20131.141). The incidence of metachronous colorectal cancer in patients with Lynch syndrome was 18.43% (95% c.i. 15.396\u201321.780), and in patients with family history 10.52% (95% c.i. 5.555\u201317.659). The proportion of metachronous colorectal cancer tumours in the microsatellite instability population was 19.7% (95% c.i. 13.583\u201327.2422).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The risk of metachronous colorectal cancer in patients with early-onset colorectal cancer is comparable to those with advanced age, but it is higher in patients with Lynch syndrome, family history and microsatellite instability. This meta-analysis demonstrates the need to personalize the management of patients with early-onset colorectal cancer according to their risk factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrae092","type":"journal-article","created":{"date-parts":[[2024,9,5]],"date-time":"2024-09-05T08:01:31Z","timestamp":1725523291000},"source":"Crossref","is-referenced-by-count":6,"title":["Risk of metachronous neoplasia in early-onset colorectal cancer: meta-analysis"],"prefix":"10.1093","volume":"8","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8322-6421","authenticated-orcid":false,"given":"Gianluca","family":"Pellino","sequence":"first","affiliation":[{"name":"Colorectal Surgery, Vall d\u2019Hebron University Hospital, Universitat Autonoma de Barcelona UAB , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giacomo","family":"Fuschillo","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Department of Advanced Medical and Surgical Sciences, Universit\u00e0 degli Studi della Campania \u2018Luigi Vanvitelli\u2019 , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rogelio","family":"Gonz\u00e1lez-Sarmiento","sequence":"additional","affiliation":[{"name":"Molecular Medicine, Biomedical Research Institute of Salamanca (IBSAL) , Salamanca ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Mart\u00ed-Gallostra","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Vall d\u2019Hebron University Hospital, Universitat Autonoma de Barcelona UAB , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Selvaggi","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Department of Advanced Medical and Surgical Sciences, Universit\u00e0 degli Studi della Campania \u2018Luigi Vanvitelli\u2019 , Naples ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloy","family":"Esp\u00edn-Basany","sequence":"additional","affiliation":[{"name":"Colorectal Surgery, Vall d\u2019Hebron University Hospital, Universitat Autonoma de Barcelona UAB , Barcelona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5522-8844","authenticated-orcid":false,"given":"Jose","family":"Perea","sequence":"additional","affiliation":[{"name":"Molecular Medicine, Biomedical Research Institute of Salamanca (IBSAL) , Salamanca ,","place":["Spain"]},{"name":"Department of Surgery, Vithas Arturo Soria University Hospital , Madrid ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,4]]},"reference":[{"key":"2024102920531459000_zrae092-B1","author":"Global Cancer Observatory (GLOBOCAN) Database"},{"key":"2024102920531459000_zrae092-B2","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1001\/jamaoncol.2016.5688","article-title":"Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 32 cancer groups, 1990 to 2015: a systematic analysis for the global burden of disease study","volume":"3","author":"Global Burden of Disease Cancer Collaboration","year":"2017","journal-title":"JAMA Oncol"},{"key":"2024102920531459000_zrae092-B3","doi-asserted-by":"crossref","first-page":"939","DOI":"10.6004\/jnccn.2018.0067","article-title":"NCCN guidelines insights: colorectal cancer screening, version 1.2018","volume":"16","author":"Provenzale","year":"2018","journal-title":"J Natl Compr Canc Netw"},{"key":"2024102920531459000_zrae092-B4","doi-asserted-by":"crossref","first-page":"359","DOI":"10.6004\/jnccn.2018.0021","article-title":"NCCN guidelines insights: colon cancer, version 2.2018","volume":"16","author":"Benson","year":"2018","journal-title":"J Natl Compr Canc Netw"},{"key":"2024102920531459000_zrae092-B5","doi-asserted-by":"crossref","first-page":"iv22","DOI":"10.1093\/annonc\/mdx224","article-title":"Rectal cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up","volume":"28","author":"Glynne-Jones","year":"2017","journal-title":"Ann Oncol"},{"key":"2024102920531459000_zrae092-B6","doi-asserted-by":"crossref","first-page":"85","DOI":"10.1016\/S0016-5085(58)80139-0","article-title":"Multiple carcinomas of the large intestine: a review of the literature and a study of 261 cases","volume":"34","author":"Moertel","year":"1958","journal-title":"Gastroenterology"},{"key":"2024102920531459000_zrae092-B7","doi-asserted-by":"crossref","first-page":"174","DOI":"10.1097\/00000658-199402000-00009","article-title":"Follow-up of patients with colorectal cancer. 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