Evidence map›Paper›PMID 40444666›Full record

ArticleANZ journal of surgery2025

The Impact of Metachronous Colorectal Neoplasia Requiring Surgery After Cessation of Colonoscopic Surveillance at Age 75.

Ammar Manasawala, John Woodfield, Kari Clifford, Mark Thompson Fawcett

Abstract read
In one paragraph

Article in ANZ journal of surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. 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

4 authors.

Ammar ManasawalaDepartment of Surgical Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand.
John WoodfieldDepartment of Surgical Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand.
Kari CliffordDepartment of Surgical Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand.ORCID 0000-0002-4908-7413
Mark Thompson FawcettDepartment of Surgical Sciences, Otago Medical School, University of Otago, Dunedin, New Zealand.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo assess the clinical and financial impact of metachronous colorectal neoplasia (MCRN) requiring surgery after cessation of colonoscopic surveillance at age 75.

methodsThe Otago Clinical Audit database was interrogated to identify all colorectal neoplasia (CRN) resections between January 2020 and November 2022 and additional patients undergoing surgery for MCRN aged ≥ 75 (MCRN ≥ 75) between 2010 and 2020. The morbidity, hospital stay, and costs of surgery for MCRN ≥ 75 cases were compared to first colorectal neoplasia (FCRN) cases ≥ 75 and to all other colorectal resections, with and without propensity matching.

resultsMCRN was identified in 3.1% of patients < 75 and 13.1% of patients ≥ 75. Identifying a further 41 patients with surgery for MCRN ≥ 75 after 2010 resulted in 55 patients with MCRN aged ≥ 75, 93 with FCRN aged ≥ 75, and 130 with CRN aged < 75. The median(IQR) age for MCRN ≥ 75 was 81 (78-86). Surgery for MCRN ≥ 75 compared to FCRN ≥ 75 resulted in complication rates of 70.9% and 50.5% (p = 0.024), hospital stay nine versus seven days (p = 0.012), readmissions 20% versus 6.5% (p = 0.026) and cost of NZD 31 021 versus 24 157 (p = 0.028). When compared to all other resections, and adjusting for different approaches to rectal cancer in elderly patients, these differences all increased. The estimated annual hospital cost for MCRN ≥ 75 surgery was NZD 317 777.

conclusionMCRN accounted for 13.1% of operations in patients aged ≥ 75. This resulted in more morbidity and cost than surgery for FCRN ≥ 75. Stopping surveillance of those with previous surgery for CRN at 75 years of age results in significant institutional cost and patient morbidity.

Indexed as

ColonoscopyColorectal NeoplasmsNeoplasms, Second PrimaryAgedAged, 80 and overAge FactorsColectomyFemaleHumansLength of StayMaleNew ZealandRetrospective Studiescolorectal surgerycolorectal surveillancemetachronous colorectal neoplasia

Identifiers

PMID40444666
PMCPMC12484390

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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.