Evidence map›Paper›PMID 27919915›Full record

SynthesisBMJ (Clinical research ed.)2016

Chemoprevention of colorectal cancer in individuals with previous colorectal neoplasia: systematic review and network meta-analysis.

Parambir S Dulai, Siddharth Singh, Evelyn Marquez, Rohan Khera, Larry J Prokop, Paul J Limburg, Samir Gupta, Mohammad Hassan Murad

Registry-linked trialOpen access · hybridAbstract readComparative StudySystematic ReviewNetwork Meta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ (Clinical research ed.), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04448652 (Effects on Omission of NSAIDs on the Consumption of Opioids in the Standard Analgesic Regimen After Elective Laparoscopic Colorectal Cancer Resection in an ERAS Setting. A Retrospective Single-center Cohort Study.), which is not on this map. Cited by 41 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
41citing papers in PubMed, 7 pooled it
5.4field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT04448652 completednot on this map

Effects on Omission of NSAIDs on the Consumption of Opioids in the Standard Analgesic Regimen After Elective Laparoscopic Colorectal Cancer Resection in an ERAS Setting. A Retrospective Single-center Cohort Study.

Typeobservational_patient_registrySponsorZealand University HospitalRan2015 to 2017Enrolled502ConditionsColo-rectal CancerArmsNSAID
3 · Its place in the literature

Who cites it

41 citing papers in PubMed, 7 syntheses or guidelines pooled it, 92 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Guideline
  5. Pooled it
  6. Pooled it
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  8. Trial
  9. Trial
  10. Review
  11. Chemopreventive strategies for sporadic colorectal cancer: a narrative review.Translational gastroenterology and hepatology · 2025
    Review
  12. Article
  13. Review
  14. Review
  15. Article
  16. Review
  17. Article
  18. Polygenic Risk Scores for Follow Up After Colonoscopy and Polypectomy: Another Tool for Risk Stratification and Planning Surveillance?Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association · 2023
    Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 5 institutions in 1 country.

Parambir S DulaiDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA.
Siddharth SinghDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA sis040@ucsd.edu.
Evelyn MarquezDivision of Gastroenterology, University of California San Diego, La Jolla, CA, USA.
Rohan KheraDivision of Cardiology, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Larry J ProkopDepartment of Library Services, Mayo Clinic, Rochester, MN, USA.
Paul J LimburgDivison of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
Samir GuptaVeterans Affairs San Diego Healthcare System, San Diego, CA, USA.
Mohammad Hassan MuradRobert D and Patricia E Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA.
University of California, San Diego · USMayo Clinic in Arizona · USThe University of Texas Southwestern Medical Center · USUniversity of San Diego · USWinnMed · US

Funding

Training Grant in GastroenterologyT32DK007202 · NIDDK · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GHOSH, PRADIPTA · 1985 to 2022
$7.7M
Training in Cardiovascular ResearchT32HL125247 · NHLBI · UT SOUTHWESTERN MEDICAL CENTER · PI JOSEPH A HILL · 2015 to 2026
$4.3M
NHLBI NIH HHS T32 HL125247NIDDK NIH HHS T32 DK007202
6 · The paper itself

Abstract

objectiveTo assess the comparative efficacy and safety of candidate agents (low and high dose aspirin, non-aspirin non-steroidal anti-inflammatory drugs (NSAIDs), calcium, vitamin D, folic acid, alone or in combination) for prevention of advanced metachronous neoplasia (that is, occurring at different times after resection of initial neoplasia) in individuals with previous colorectal neoplasia, through a systematic review and network meta-analysis. DATA SOURCES: Medline, Embase, Web of Science, from inception to 15 October 2015; clinical trial registries. STUDY SELECTION: Randomized controlled trials in adults with previous colorectal neoplasia, treated with candidate chemoprevention agents, and compared with placebo or another candidate agent. Primary efficacy outcome was risk of advanced metachronous neoplasia; safety outcome was serious adverse events. DATA EXTRACTION: Two investigators identified studies and abstracted data. A Bayesian network meta-analysis was performed and relative ranking of agents was assessed with surface under the cumulative ranking (SUCRA) probabilities (ranging from 1, indicating that the treatment has a high likelihood to be best, to 0, indicating the treatment has a high likelihood to be worst). Quality of evidence was appraised with GRADE criteria.

results15 randomized controlled trials (12 234 patients) comparing 10 different strategies were included. Compared with placebo, non-aspirin NSAIDs were ranked best for preventing advanced metachronous neoplasia (odds ratio 0.37, 95% credible interval 0.24 to 0.53; SUCRA=0.98; high quality evidence), followed by low-dose aspirin (0.71, 0.41 to 1.23; SUCRA=0.67; low quality evidence). Low dose aspirin, however, was ranked the safest among chemoprevention agents (0.78, 0.43 to 1.38; SUCRA=0.84), whereas non-aspirin NSAIDs (1.23, 0.95 to 1.64; SUCRA=0.26) were ranked low for safety. High dose aspirin was comparable with low dose aspirin in efficacy (1.12, 0.59 to 2.10; SUCRA=0.58) but had an inferior safety profile (SUCRA=0.51). Efficacy of agents for reducing metachronous colorectal cancer could not be estimated.

conclusionsAmong individuals with previous colorectal neoplasia, non-aspirin NSAIDs are the most effective agents for the prevention of advanced metachronous neoplasia, whereas low dose aspirin has the most favorable risk:benefit profile. REGISTRATION: PROSPERO (CRD42015029598).

Indexed as

Anti-Inflammatory Agents, Non-SteroidalAspirinBayes TheoremCalciumChemopreventionColorectal NeoplasmsFolic AcidHumansVitamin B ComplexVitamin DVitaminsAnti-Inflammatory Agents, Non-SteroidalAspirinCalciumFolic AcidVitamin B ComplexVitamin DVitamins

Identifiers

PMID27919915
PMCPMC5137632
OpenAlexW2560143099

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.